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目的探讨尿动力学检测在糖尿病患者良性前列腺增生(BPH)手术评估中的意义。方法对180例BPH伴糖尿病患者进行尿动力学检测,将逼尿肌收缩强度分为6级:极弱(VW)、弱减(W-)、弱加(W+)、正常减(N-)、正常加(N+)和强烈(ST),把相应的患者分为6组,除了逼尿肌收缩极弱组保守治疗外,其余均行经尿道前列腺切除术(TURP)。结果 180例患者存在不同程度的膀胱出口梗阻(BOO)。124例患者表现为逼尿肌收缩力降低,21例术后出现排尿困难,其中13例经药物和针灸治疗后好转,7例治疗无效,因残余尿量增多而留置尿管。17例术后尿失禁,经药物和针灸治疗后好转,该类患者最大逼尿肌压均大于最大尿道闭合压。结论良性前列腺增生合并糖尿病患者应通过尿动力学检查明确逼尿肌功能状态损害程度,以准确选择手术时机。逼尿肌收缩力为极弱患者,不宜行TURP,建议保守治疗,溴吡斯的明和巴氯芬等药物治疗TURP术后排尿困难效果良好。
Objective To investigate the significance of urodynamic tests in the evaluation of benign prostatic hyperplasia (BPH) in diabetic patients. Methods 180 cases of BPH patients with diabetes mellitus were tested for urodynamics. Detrusor contractility was divided into 6 grades: VW, W-, W +, N- , Normal plus (N +) and intense (ST). The corresponding patients were divided into 6 groups. All patients underwent conservative transurethral resection of the prostate (TURP) except conservative treatment of very weak detrusor contractions. Results 180 patients had varying degrees of bladder outlet obstruction (BOO). 124 cases of patients showed detrusor contractility reduced 21 cases of dysuria after surgery, of which 13 cases after treatment by drugs and acupuncture improved, 7 cases of treatment ineffective, due to increased residual urine retention catheter. 17 cases of postoperative urinary incontinence, after the drug and acupuncture treatment improved, the maximum detrusor pressure in these patients were greater than the maximum urethral closure pressure. Conclusions Patients with benign prostatic hyperplasia with diabetes mellitus should confirm the extent of detrusor dysfunction through urodynamic examination in order to accurately select the timing of the operation. Detrusor contractility for very weak patients, should not line TURP, it is recommended conservative treatment, bromopyrazine and baclofen and other drugs TURP surgery dysuria effect is good.