良性前列腺增生伴逼尿肌收缩无力的手术疗效分析及预判参数研究

Efficacy of urodynamic in the treatment of patients with BPH and detrusor underactivity

目的：探讨经尿道前列腺电切术（TURP）治疗良性前列腺增生（BPH）伴膀胱逼尿肌收缩无力的效果及预测其疗效的尿动力学参数。方法对57例术前尿动力学检查提示膀胱出口梗阻并伴有逼尿肌收缩无力的BPH患者予以TURP治疗，观察术后患者的症状及排尿情况，并将术前尿动力学参数与术后的排尿后剩余尿量及最大尿流率之间的相关性进行分析。结果本组患者术后国际前列腺症状评分（IPSS）、生活质量评分（QoL）、最大尿流率（Qmax）、残余尿量（PVR）均有显著改善，术前与术后比较，差异有统计学意义（P＜0.05）。相对膀胱出口梗阻参数比膀胱出口梗阻指数、膀胱收缩指数与术后PVR及Qmax有更强的相关性。结论对合并逼尿肌收缩无力的BPH患者行TURP手术治疗，能取得良好的效果。相对膀胱出口梗阻参数比其它尿动力学参数对伴膀胱逼尿肌收缩无力的BPH患者的治疗抉择和疗效预测有更重要价值。

Objective To evaluate the efficacy of transurethra1 resection of the prostate （TURP） in patients with benign prostatic hyperplasia and detrusor underactivity , and explore the relationship between urodynamic praraneters and efficacy of TURP. Methods 57 BPH patients with bladder outlet obstruction and detrusor contractility were treated by TURP. Surgical outcome was observed during follow-up.The relationship between urodynamic parameters and postoperative PVR and Qmax with was assessed. Results There were the significant differences in IPSS, PVR, QoL,Qmax between the preoperative and the postoperative cases （P〈0.05）. The patients had significant surgical outcomes after TURP. The relationship between parameters of BOOI/BCI and postoperative PVR and Qmax was closer than the relationship between BOOI、BCI and PVR. Conclusion TURP shows a satisfactory outcome in the treatment of patients with BPH and detrusor underactivity.The parameters of relative bladder outlet obstruction reveal an important value in bladder emptying prediction and thus clinical application.