论文部分内容阅读
目的:探讨压力-流率测定结合膀胱镜检在女性膀胱出口梗阻(FBOO)患者手术评估的意义。方法:对35例怀疑FBOO患者进行压力-流率测定,将最大尿流率时逼尿肌压力(Pdet.Qmax)>4.90kPa,最大尿流率<15ml/s作为评估是否存在FBOO标准,同时行膀胱镜检示不同程度膀胱颈后唇抬高,隆起,可见膀胱憩室和膀胱小梁。术前逼尿肌收缩强度分为六级:极弱(VW)、弱减(W-)、弱加(W+)、正常减(N-)正常加(N+)和强烈(ST),把相应的患者分为六组,除了逼尿肌收缩极弱组保守治疗外,均行经尿道膀胱颈切开术。结果:35例患者存在不同程度的膀胱出口梗阻(BOO),3例术后尿失禁,经药物和针灸治疗后好转。结论:FBOO患者应通过压力-流率测定结合膀胱镜明确诊断,明确逼尿肌功能状态损害程度,以准确选择手术时机。逼尿肌收缩力正常下行经尿道膀胱颈切开术是治疗FBOO的最佳治疗方案。
Objective: To investigate the significance of pressure-flow rate assay combined with cystoscopy in assessing the surgical outcome of female patients with bladder outlet obstruction (FBOO). Methods: The pressure-flow rate was measured in 35 patients with suspected FBOO. The maximum flow rate of detrusor pressure (Pdet.Qmax)> 4.90 kPa and the maximum flow rate of urine <15 ml / s were used to evaluate the existence of FBOO standard. Meanwhile, Cystoscopy showed varying degrees of bladder neck posterior lip elevation, uplift, showing bladder diverticulum and bladder trabecular. Preoperative detrusor contractility was divided into six levels: VW, W-, W +, N + and ST, Of patients were divided into six groups, in addition to conservative treatment of very weak detrusor contraction group, both underwent transurethral bladder neck incision. Results: 35 patients had varying degrees of bladder outlet obstruction (BOO), 3 cases of postoperative urinary incontinence, improved after treatment with drugs and acupuncture. Conclusion: FBOO patients should be diagnosed by pressure-flow rate combined with cystoscopy to confirm the degree of detrusor dysfunction so as to accurately select the timing of operation. Detrusor contractility normal down transurethral bladder neck incision is the best treatment for the treatment of FBOO.