膀胱收缩指数与前列腺电切术预后的关系

Relationship between bladder contractility index and prognosis of transurethral resection of prostate

目的探讨膀胱收缩指数(bladder contractility index,BCI)与经尿道前列腺切除术(ransurethral resection of the prostate,TURP)预后的关系。方法回顾性分析147例良性前列腺增生症(benign prostatic hyperplasia,BPH)患者行TURP手术的临床资料,按术前BCI数值大小进行分组:A组(80例)BCI<100、B组(67例)BCI≥100,比较两组内、组间手术前后国际前列腺症状学评分(IPSS)、最大尿流率(Qmax)及残余尿量(post voiding residual,PVR)的差异,以及比较两组间手术前后差值参数d-IPSS、d-Qmax和d-PVR的差异。结果A、B两组的术后IPSS、PVR数值较术前显著下降及术后Qmax数值较术前明显增加,差异有统计学意义(P<0.01)。A组术后IPSS高于B组(P=0.024),A组术前Qmax低于B组(P=0.008),A组术前PVR、术后PVR及手术前后差值d-PVR均多于B组(P=0.01、0.004、0.031),而A、B两组的术前IPSS评分、术后Qmax、d-IPSS及d-Qmax组间比较,差异无统计学意义(P>0.05)。结论无论BCI是否大于100,BPH患者经TURP治疗,术后排尿情况均较术前明显改善。以BCI=100为界值,BCI的高低可以反映患者术前逼尿肌收缩能力,与术后PVR改善情况关系密切,但与术后Qmax改善情况无明显相关。

Objective To explore the relationship between bladder contractility index(BCI)and prognosis of transurethral resection of the prostate(TURP).Methods Clinical data of 147 patients with benign prostatic hyperplasia(BPH)who underwent TURP were collected retrospectively.Patients were divided into group A(80 cases,BCI<100)and group B(67 cases,BCI≥100),according to the preoperative BCI values.International prostate symptom scores(IPSS),maximum urinary flow rate(Qmax)and post voiding residual(PVR)were compared before and after surgery in two groups respectively,and comparison between the two groups in pre-and postoperative IPSS,Qmax and PVR and improved values including d-IPSS,d-Qmax,and d-PVR were performed.Results Postoperative IPSS and PVR significantly decreased but Qmax significantly increased after the operation in the two groups(P<0.01).Postoperative IPSS of group A was higher than that of group B(P=0.024)but preoperative Qmax in group A was lower than that in group B(P=0.008).There were no statistical differences between two groups in preoperative IPSS and postoperative Qmax and d-IPSS and d-Qmax(P>0.05).There were statistical differences between two groups in pre-and post-operative PVR(P>0.05).Conclusions Micturition of patients with BPH after TURP was significantly improved regardless of whether BCI is greater than 100 or not.BCI can be used as an indicator to reflect the ability of patient to contract the detrusor,and is closely related to PVR,but it has no significant correlation with Qmax and IPSS.