尿动力与前列腺增生关系的定量化研究

Quantitative research on the relationship between urinary dynamics and benign prostatic hyperplasia

目的观察探讨前列腺增生患者尿动力学特点，总结尿动力与前列腺增生的关系。方法选取本院2013年3月至2014年11月收纳的98例前列腺增生症患者，均留置尿管进行尿动力学检查。一周后按是否存在逼尿肌过度活动现象分为观察组和对照组。观察组为逼尿肌过度活动的前列腺增生患者，对照组为无逼尿肌过度活动的前列腺增生患者，各49例。分析尿流动力学参数中最大逼尿肌压力等指标差异，总结尿动力与前列腺增生关系的定量化关系。结果AUCdet／Vol诊断相较于传统方法的准确率为67例，即符合率为68．38％（67／98），其中诊断出无梗阻的几率为90％（27／30），可疑梗阻的几率为42．30％（11／26），梗阻的几率为69．04％（29／42）。诊断出无梗阻几率高于可疑梗阻及梗阻，差异有统计学意义（P〈0．05）。两组患者尿动力学参数在最大逼尿肌压力（cmH2O）、直线被动尿道阻力梗阻分级、初始感觉时膀胱容量（mL）、膀胱顺应值、测量容积（mL）具有明显差异，有统计学意义（P〈0．05）。结论尿动力学检查可明确前列腺增生患者膀胱功能状态，逼尿肌过度活动的患者膀胱容量、尿道阻力关系及梗阻程度均大于非过度活动组患者。前列腺增生患者进行尿动力检查，有利于提前防治膀胱出口梗阻引起的急性尿潴留等情况，及早恢复膀胱功能及减轻患者尿路功能损害。

Objectives To investigate the characteristics of urinary dynamics in patients with benign prostatic hyperplasia, and to sum up the quantitative research on the relationship between the urinary dynamics and benign prostatic hyperplasia. Methods 98 cases of benign prostatic hyperplasia in our hospital from March 2013 to November 2014 were collected, and the urinary dynamics of the indwelling catheter was performed. After a week, the patients were divided into observation group and control group according to the existence of detrusor overactivity. The benign prostatic hyperplasia patients with detrusor overactivity were referred to the observation group, and the benign prostatic hyperplasia patients without detrusor overactivity were referred to the control group （49 cases each group）. The urine flow dynamics parameters, maximum detrusor pressure indicators was analyzed on the difference. The relationship between urinary dynamic and benign prostatic hyperplasia of the quantitative was summarized. Results The accuracy rate of AUCdet / Vol was 68.38% （67/98） , without abstraction was 90% （27/30）, suspected abstraction and abstraction was 42.30% （11/26）, 69.04% （29/42） respectively. The rate of without obstruction was higher than suspected obstruction and obstruction, and there were significant differences （ P 〈 0. 05 ）. There was statistically significant difference in the maximum detrusor pressure （cmH2O） , linear passive urethral resistance level of obstruction, bladder volume of initial feeling （mL）, bladder compliance value and measurement volume （mL） between the two groups （ P 〈 0.05）. Conclusions Urodynamic examination could correctly diagnose the benign prostatic hyperplasia Bladder function, detrusor overactivity bladder capacity, urethral resistance relation and the degree of obstruction were greater than non excessive activity of the patients. It＇s beneficial to prevent and cure the bladder outlet obstruction caused by acute urinary retention and other conditions which could make patients recover bladder function and reduce the urinary tract damage for paitients with benign prostatic hyperplasia by urodynamics examination.