脑卒中合并前列腺增生患者尿动力学变化与疗效评价

Urodynamic assessment and treatment strategies of benign prostatic hyperplasia following cerebrovascular accident

目的探讨脑卒中合并前列腺增生(BPH)患者的尿动力学变化及临床治疗效果评价评价。方法选取2009~2014年72例脑卒中合并BPH患者的尿动力学和治疗效果的资料,总结脑卒中合并BPH的尿动力学特点,并根据其尿动力学表现给予相应临床治疗并研究疗效。结果 72例患者中47例存在梗阻,9例有可疑梗阻,16例不伴有梗阻。47例有膀胱逼尿肌反射亢进,16例有膀胱逼尿肌降低或减弱,6例有逼尿肌-尿道括约肌不协调。临床治疗1周与1个月后生活质量(QOL)评分及国际前列腺症状(IPSS)与治疗前比较,差异有统计学意义(P<0.05)。结论脑卒中合并BPH患者尿动力学参数变化较不伴有BPH脑卒中更为复杂,临床结合不同的尿动力学检查结果制定相应的治疗策略有助于改善患者的临床症状和生活质量。

Objective To explore the urodynamic change of benign prostatic hyperplasia （BPH） following cerebrovascular accident and evaluate its treatment strategies. Methods The urodynamic data and treatment efficacy of 72 patients with BPH following cerebrovascular accident were collected from 2009 to 2014. Their urodynamics characteristics were retrospectively summarized. The corresponding clinical treatment was recommended to the patients based on the urodynamics characteristics and the treatment efficacy was observed. Results Among 72 patients, the bladder outlet obstruction （BOO） were observed in 47 patient. No BOO were found in 16 patients and equivocal obstruction were noted in 9 patients. We found that 47 cases had definite detrusor hyperreflexia and 16 cases had detrusor underactivity, whereas 6 cases had detrusor - external sphincter dyssynergia. After clinic treatment of one week and one month based on their urodynamics characteristics, there were significant differences in QOL and IPSS scores compared with before intervention （P^0.05）. Conclusion The changes of urodynamics parameters of BPH following cerebrovascular accident are more complex than those of cerebrovascular accident without BPH. The corresponding clinic treatment based on their urody- namics characteristics may contribute to the improvement of quanlity of life.