前列腺增生患者膀胱出口梗阻程度对尿动力学指标影响.docVIP

前列腺增生患者膀胱出口梗阻程度对尿动力学指标影响 　 作者：何有华　陈映鹤　竺海波　张磊　陈志勇　杨世坤　饶大庞　虞海锋 【摘要】 　　目的 探讨前列腺增生患者膀胱出口梗阻程度对尿动力学指标的影响及临床意义。方法 分析113例前列腺增生患者的尿动力学资料，根据膀胱出口有无梗阻分为梗阻组和非梗阻组，梗阻组又根据梗阻级别分Ⅲ、Ⅳ、Ⅴ、Ⅵ级四组。结果 梗阻组的最大尿流率、膀胱顺应性值和逼尿肌收缩力减弱发生率明显低于非梗阻组，逼尿肌不稳定和急性尿潴留发生率明显高于非梗阻组。梗阻组内各梗阻级别之间在顺应性值、逼尿肌不稳定和急性尿潴留的发生率上无显著性差异，随梗阻级别增加尿流率和逼尿肌收缩功能受损发生率下降。结论 一些反映排尿异常和逼尿肌功能的尿动力学指标受膀胱出口梗阻程度影响，在无法进行压力/流率分析时综合分析这些指标有助于判断出口梗阻及其程度。 【关键词】 前列腺增生　膀胱出口梗阻　尿动力学 　　The influence of the grade of bladder outlet obstruction on urodynamic parameters in patients with benign prostatic hyperplasia 　　ABSTRACT: Objective To study the influence of the grade of bladder outlet obstruction (BOO) on urodynamic parameters in patients with benign prostatic hyperplasia (BPH) and its clinical value. Methods The urodynamic data of 113 patients with BPH were studied. The 113 patients were divided into the BOO group and the nonBOO group. And the BOO group was divided into 4 groups according to the grade of BOO: the grade Ⅲ, grade Ⅳ, grade Ⅴ and grade Ⅵ group. Results The maximum urine rate(Ｑmax), the value of bladder compliance (BC) and the incidence of detrusor underactivity (DUA) were lower in the BOO group than in the nonBOO group while the incidence of detrusor instability (DI) and acute urine retention (AUR) were higher. Among the grade Ⅲ, grade Ⅳ, grade Ⅴ and grade Ⅵ groups, there was no statistically significant difference in these urodynamic parameters except Ｑmax and the incidence of DUA. Conclusion The urodynamic parameters reflecting abnormal voiding and detrusor function are associated with BOO and its grades. If there is no definite pressureflow (PF) finding some other urodynamic parameters is very helpful in evaluating BOO and its grades. 　　KEY WORDS: benign prostatic hyperplasia; bladder outlet obstruction; urodynamics 　　良性前列腺增生(benign prostatic hyperplasia, BPH)是老年男性的常见病，症状严重时影响生活质量，最终常导致肾积水、膀胱结石、出血、感染等并发症。BPH最基本的病理改变是膀胱出口梗阻(bladder outlet obstruction, BOO)和逼尿肌功能改变，BOO的程度与BPH的临床表现、合并症、治疗方法的选择及治疗效果密切相关[1]。本研究试图通过尿动力学的方法进一步了解BPH患者BOO程度对