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目的评估幌并急性尿潴留(AUR)的良性前列腺增生(BPH)患者逼尿肌功能,预测术后疗效。方法对23例合并AUR的BPH患者术前后行尿动力学检查,评估逼尿肌功能(包括逼尿肌紊定性、顺应性、收缩功能),在治疗成功组与失败组之间进行比较。结果23例患者中,16例(70%)发生逼尿肌无抑制性收缩(DI),幅度5~168 cm H2O,平均(98±33)cm H2O(1cm H2O=0.098 kPa);20例(87%)可见有逼尿肌随意收缩;所有患者均明确诊断膀胱出口梗阻(BOO);4例(17%)患者术后不能排尿,需要留置导尿。手术前后患者年龄、DI的发生率、DI幅度、膀胱顺应性及测压容量、逼尿肌收缩力强弱在治疗成功组与失败组之间的差异具有统计学意义(P<0.05)。结论合并AUR的BPH患者留置尿管10 d后行尿动力学检查,可以预测术后疗效。术前尿动力学检查DI幅度越大,逼尿肌收缩力越强,术后疗效越好;术前膀胱顺应性及测压容量异常增高、无DI出现者术后疗效差。
Objective To evaluate the detrusor function in patients with benign prostatic hyperplasia (BPH) and acute urinary retention (AUR) and to predict the postoperative efficacy. Methods Twenty-three patients with BPH complicated with AUR underwent preoperative and postoperative urodynamic tests to evaluate detrusor function (including detrusor instability, compliance, systolic function) and compared between successful and failed treatment groups. Results Among the 23 patients, no detrusor constriction (DI) occurred in 16 patients (70%), ranging from 5 to 168 cm H2O with an average of (98 ± 33) cm H2O (1 cm H2O = 0.098 kPa) 87%) showed detrusor voluntary contraction; all patients were diagnosed with bladder outlet obstruction (BOO); 4 patients (17%) patients can not urinate after surgery, the need for indwelling catheterization. The difference of age, DI rate, DI amplitude, bladder compliance, manometry capacity and detrusor contractility between before and after treatment were statistically significant (P <0.05). Conclusions Urine biopsy was performed in 10 BPH patients with BPH after AUR, which could predict the postoperative efficacy. Preoperative urodynamic examination DI amplitude greater detrusor contractility, the better postoperative efficacy; preoperative bladder compliance and manometry abnormally increased capacity, no signs of adverse outcomes after surgery.