尿流动力学在前列腺增生症诊断中的价值
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Diagnosis value of urodynamics in patients with benign prostate hypertrophy
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    摘要:

    目的 评价尿流动力学检查在诊断前列腺增生所致的下尿路症候群中的价值。方法 采用Life-Tech尿流动力学检查仪常规行尿流率、压力-流率测定及尿道测压,并测尿道外括约肌肌电图及残余尿量;记录膀胱逼尿肌情况,膀胱顺应性和尿道外括约肌协调情况,应用A-G图、P-Q图及DS诊断BOO(膀胱出口梗阻)。结果 本组患者427例,348例诊断为BOO,73例可疑,6例无BOO。其中伴膀胱低顺应性162例,膀胱逼尿肌功能受损117例,尿道外括约肌功能失调148例,不稳定膀胱164例。随着BOO程度加重Pdet-Qmax、Popen、DS、IPSS积分及前列腺体积呈升高趋势,膀胱顺应性、Qmax呈下降趋势。结论 尿流动力学检查在前列腺增生症诊断评估中极其重要。BOO程度与Pdet-Qmax、Popen、DS、IPSS积分及前列腺体积呈正相关,与膀胱顺应性、Qmax呈负相关。

    Abstract:

    Objective To evaluate the diagnosis value of urodynamics in patients with benign prostate hypertrophy(BPH).Methods With urodynamic device,the full set of urodynamic exam was administrated in 427 patients with BPH,and the externalsphincter urethral myogram was monitored simultaneously in pressure-flow studies(PFS).The umdynamic finding such as Qmax 、Pdet-Qmax、Popen、DS(descending slope) and post-voiding residual(PVR)were recorded,as well as the situation of bladder detrusor constraction and bladder compliance and urethral sphincter coordination. The bladder outflow obstruction was diagnosed by A-G nomogram,P-Q plot and DS.The IPSS score and prostate volume were also acquired. Results The diagnostic rate of BOO is 81.5%,among them concomitantly detrusor muscle impair in 117 cases(27.4%), decreased bladder compliance in 162 case (37.9%),urethral sphincter dyssynergia in 148 cases(34.7%),and unstable bladder in l64 cases (38.4%). The increase degree of BOO show an increasing tendency with urodynamic findings such as Qmax ,Pdet-Qmax,Popen,DS and IPSS score and prostatic volume respectively,however a decreasing tendency with Qmax and bladder compliance. Conclusions The urodynamic exam plays an important role in diagnosis of BOO.There is a positive relation among degree of BOO with urodynamic finding such as Pdet-Qmax,Popen,DS and IPSS score and prostatic volume,however,negative relation with Qmax and bladder compliance respectively.

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周智华,王亚伟,应亮,罗明,邱丰.尿流动力学在前列腺增生症诊断中的价值[J].医用生物力学,2010,25(1):74-76

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