前列腺增生症患者尿动力学检测临床意义.docVIP

前列腺增生症患者尿动力学检测临床意义[摘要] 目的:探讨尿动力学测定在前列腺增生症患者预测手术疗效的价值及能否用于选择手术的临床意义。方法:对有完整尿动力学压力-流率测定资料的67例BPH患者手术前后的国际前列腺症状评分(IPSS)和最大尿流率进行调查。结果:67例患者中膀胱出口梗阻(BOO)65例,2例患者为可疑BOO。存在BOO的65例患者行标准经尿道等离子体前列腺电切术,术后国际前列腺症状评分(IPSS)(16.4±2.6)分较术前(26.3±6.8)分明显降低(P0.05)。结论:尿动力学检查具有直观、准确、量化及可比性高等优点,对BPH患者BOO确诊、判断逼尿肌功能、选择术式及预测疗效等均有重要的参考价值。 [关键词] 前列腺增生;尿动力学;国际前列腺症状评分(IPSS) [中图分类号] R697.32[文献标识码]A [文章编号]1673-7210(2010)04(a)-047-02 Dianostic value of urinary dynamic for BPH WANG Hui, YUE Huiqing, GENG Dewei (Department of Urology, the Traditional Chinese Medical Hospical of Fuxin City, Fuxin123000, China) [Abstract] Objective: To explore the predicted value of determination on urodynamics in the patitents with benign prostatic hyperplasia and in the clinical significance of surgery. Methods: 67 cases of patients with benign prostatic hyperplasia (BPH) were evaluated with urodynamics. All the patients were adopted to IPSS evaluation and the maximum-flow rate between preoperation and postoperation. Results: Of the 67 cases who underment the pressure-flow studies, 65 cases were found in bladder outlet obstruction (BOO), 2 cases were suspicious. 65 cases with BOO were performed transurethral bipolar plasmakinetie. The changes of IPSS score and the maximum-flow rate had a significant difference postoperatively (P0.05). Conclusion: Currently pressure-flow study is the only method and gold standard for diagnosis of BOO. The urinary dynamics test is valuable to the assessment of applications and the curative effect. [Key words] Benign prostatie byperplasia; Urinary dynamic study; IPSS 经尿道等离子体前列腺电切术(TUVP)是解除前列腺增生症(BPH)患者排尿困难的有效方法,但有一部分患者术后症状改善不满意。为了探讨尿动力学测定预测手术疗效的价值及能否用于选择手术,2008年1月～2009年11月,笔者对有完整尿动力学压力-流率测定资料的67例BPH患者手术前后的国际前列腺症状评分(IPSS)和最大尿流率(Qmax)进行了调查。现报道如下: 1 资料与方法 1.1 一般资料 本组67例,年龄52～83岁,平均66.7岁;均有尿路梗阻症状,病程1～12年,平均5.5年。患者均经直肠指诊、血清前列腺特异抗原(PSA)提示、有直肠超声检查确诊为良性前列腺增生症。病史提示有心脑血管意外、糖尿病和其他可能影响到膀胱功能的神经系统疾病者均排出在本研究之外。患者术前平均IPSS为(26.3±6.8)分,Qmax为(5.9±1.8) ml/s,患者65例行标准行TUVP,术后随