膀胱逼尿肌压力与良性前列腺增生患者TURP术后排尿情况相关性分析

Correlation analysis of TURP postoperative micturition in patients with benign prostatic hyperplasia and bladder detrusor pressure

目的:对膀胱逼尿肌压力与良性前列腺增生患者TURP术后排尿情况相关性分析,指导临床应用。方法:自2013年2月至2016年7月我院共收入确诊为良性前列腺增生且需行TURP术的患者200例,患者年龄在50~88岁,平均年龄为69岁,术前测定所有患者最大逼尿肌压力(Pdet_(max)),术前和术后均对患者进行前列腺症状评分(IPSS)、尿动力学检查最大尿流率(Q_(max))、残余尿量(PVR)评分测定。结果:按照FI等级将所有患者划分为非常好、好、一般、无效四组。各组术前测定的Pdet_(max)分别为(101.2±35.9)、(73.8±24.6)、(61.0±32.2)、(41.4±8.0)cm H_2O,各组之间差异具有统计学意义(P<0.05)。测定后按照SI将患者分为非常好、好、一般、无效四组。各组术前测定的Pdet_(max)分别为(102.5±39.0)、(94.9±44.6)、(71.1±28.2)、(17.4±4.2)cm H_2O,各组之间差异具有统计学意义(P<0.05)。残余尿量在14.2m L^20.0m L的患者有124例,20.0m L^25.0m L的患者有62例,25.0m L^30.0m L的患者有10例,30.0m L^34.7m L的患者有4例。各组术前测定的Pdet_(max)分别为(100.78±23.5)、(87.4±39.6)、(66.5±33.4)、(18.2±6.7)cm H_2O,各组之间差异具有统计学意义(P<0.05)。结论:膀胱逼尿肌压力与良性前列腺增生患者TURP术后排尿情况具有相关性,膀胱逼尿肌压力较小时,术后排尿情况较差。因此术前测定Pdet_(max)有利于判断术后疗效,判断预后。

Objectives：To analyze the correlation of TURP postoperative micturition in patients with benign prostatic hyperplasia（BPH） and bladder detrusor pressure in order to provide guidance for its clinical application.Methods：200 patients diagnosed with BPH and received TURP in our hospital from February 2013 to July 2016 in our hospital were selected.All the patients were between 50 to 88 years old,an average age of 69 years old.The preoperative maximum detrusor pressure（Pdet.max） was detected,and the preoperative and postoperative international prostate symptom score（IPSS）,urodynamic maximal urinary flow rate（Qmax） and residual urine volume（PVR） score was detected.Results：All the patients were divided into four groups of very good,good,general and ineffective group according to FI grade.The preoperative Pdet.max in the four groups were（101.2 ± 35.9）,（73.8± 24.6）,（61.0 ± 32.2） and（41.4 ± 8.0） cm H2O respectively,with statistically significant difference among groups（P 〈 0.05）.The patients were further divided into very good,good,general and ineffective four groups according to SI.The preoperative Pdet.max in the four groups were（102.5 ± 39.0）,（94.9 ± 44.6）,（71.1 ±28.2）,（17.4 ± 4.2） cm H2O respectively,with statistically significant difference among groups（P 〈 0.05）.There were 124 patients with residual urine volume of 20.0m L 14.2m L,62 patients with residual urine volume of25.0m L 20.0m L,10 patients with residual urine volume of 25 30.0m L and 4 patients with residual urine volume of 34.7m L 30.0m L.The preoperative Pdet.max in the above four groups were respectively（100.78 ± 23.5）,（87.4 ± 39.6）,（66.5 ± 33.4） and（18.2 ± 6.7） cm H2O,with statistically significant difference（P 〈 0.05）.Conclusion：The bladder detrusor pressure and TURP postoperative micturition in patients with BPH is closely related,poor postoperative micturition for patients with small bladder detrusor pressure.Therefore,preoperative determination of Pdet.max is beneficial to judge the postoperative curative effect and prognosis.