良性前列腺增生患者膀胱内前列腺突入测定的临床意义

目的探讨良性前列腺增生（BPH）患者前列腺突入膀胱内的程度对膀胱出口梗阻及逼尿肌功能的预测与评价。方法以经腹超声证实前列腺突入膀胱内的BPH患者为研究组，无突入的患者为对照组，分析两组间临床资料及尿动力学检查结果的关系。结果研究组临床资料中，前列腺体积、残余尿量、急性尿潴留及膀胱小梁化的比率与对照组相比差异有统计学意义（p〈0．05），膀胱内前列腺突入程度与前列腺体积、残余尿量呈正相关（r分别为0．401，0．342，p值分别为0．013，0．0231）；在尿动力学结果中，研究组排尿期最大尿流率（Qmax）、逼尿肌不稳定及低顺应性膀胱的比率与对照组相比差异显著（p〈0．01），排尿期最大逼尿肌压力（Pdet.max）及梗阻指数显著高于对照组（p〈0．05），膀胱内前列腺突入程度与Qmax呈负相关（r=-0．284，p=0．045），与Pdet．max及膀胱出口梗阻指数（BOOI）呈正相关（r分别为0．252，0．456，p值分别为0．041，0．032）。结论前列腺突入膀胱的BPH患者膀胱出口梗阻及膀胱功能受损的程度明显高于无突入患者；经B超测定膀胱内前列腺突入的程度，可以预测及评价膀胱出口梗阻的程度和膀胱功能的改变。

The clinic significance of measurement of intravesical prostatic protrusion of benign prostatic hyperplasia

Objectives To investigate the significance of intravesical prostatic protrusion (IPP) degree using transabdominal ultrasonography measurement on bladder outlet obstruction (BOO) and function of detrusor in patients with benign prostatic hyperplasia (BPH). Methods Patients were ascribed to experimental group,who were proved the IPP using transabdominal ultrasonography.Patients without IPP were as control group.The relationship of clinic data and urodynamic outcome was analysed between the two groups . Results In the clinic data ,there was statistical significance in the prostate volume , the postvoid residual urine volume, the ratio of acute urine retension and bladder trabeculation between the two groups (p<0.05) .There was positive correlation between IPP and prostate volume,as well as IPP and postvoid residue (r= 0.401,0.342;p=0.013,0.0231, repectively). In the urodynamic data ,there was distinctly difference in the peak uroflow (Qmax) and ratio of detrusor instability and low compliance of bladder between the two groups(p<0.01) . There was statistical significance of the maximum detrusor pressure (Pdet.max) and BOO index (BOOI) between the two groups (p<0.05) . There was positive correlation between IPP and Pdet.max , as well as IPP and BOOI(r=0.252,0.456;p=0.041, 0.032, respectively ), there was negative correlation between IPP and Qmax(r=-0.284,p=0.045). Conclusions The extent of BOO and impaired function of detrusor in IPP patients are more severe than the patients without IPP.The measurement the IPP by transabdominal ultrasonography can predict the the extent of BOO and function of detrusor of BPH.