保留尿道内括约肌腔内前列腺切除压力-流率的临床研究

目的应用尿动力学检查指标对保留尿道内括约肌腔内前列腺切除术后的尿动力学改变进行研究。方法240例BPH患者采用电汽化或等离子汽化治疗,术前、术后的国际症状评分和尿动力学检查。结果最大尿流率(Qmax)由术前(8.02±4.02)mL/s增加至术后的(17.83±4.78)mL/s,最大尿流量术前的(143.33±57.63)mL增加至术后的(245.56±68.73)mL,术前残余尿(PVR)为(87.92±73.47)mL减少至术后的(9.31±8.49)mL,IPSS评分由术前23.44分降至10.73分,剩余分数(RF)由术前的(0.54±0.22)降至术后的(0.03±0.05),最大尿流率时膀胱逼尿肌压由术前的78.41cmH2O下降至术后的38.68cmH2O,膀胱颈压由术前的36.35cmH2O下降至术后的8.26cmH2O,膀胱顺应性由术前的22.76mL/cmH2O上升至术后的41.22mL/cmH2O。RF与Qmax呈显著负相关(r=-0.253,P<0.01),PRV与Qmax呈显著负相关(r=-0.220,P<0.05)。RF与PRV呈正相关(r=0.2870,P<0.05)。A一D组间差异无显著性(P>0.05)。结论该研究以客观的指标证实保留尿道内括约肌腔内前列腺切除可切实地解除由BPH所致的膀胱流出道梗阻改善膀胱功能。

Pressure flow studies in preserving uretha inner sphincter within cavity prostatic resection

Objective] To use urodynamic parameters to evaluate the outcome of patients with BPH who were treated with preserving uretha inner sphincter within cavity prostatic resection.Methods] 240 cases were treated with transurethral electrovaporization or plasmakinetic energy resection of prostate,and were evaluated pre-operatively and postoperatively with International Prostatic Symptom Score(IPSS)and urodynamics.Results] Peak Outflow Rate(Qmax)increased from 8.02 mL/s to 17.83 mL/s.Most urine flux increased from 143.33 mL to 245.56 mL.PVR decreased from 87.92 mL to 9.31 mL.IPSS decreased from 23.44 to 10.73.RF decreased from 0.54 to 0.03.Detrusor pressure at peak flow decreased from 78.41 cmH2O to 38.68 cmH2O.Bladder compliance increased from 22.76 mL/cmH2O to 41.22 mL/cmH2O.The coefficient between RF and Qmax showed extremely negative correlation(r =-0.253,P <0.01).Also,PRV and Qmax showed significant negative correlation(r =-0.220,P <0.05).RF and PVR showed positive correlation(r = 0.287,P <0.05).The groups between A to D showed no difference.Conclusions] This study provides objective evidence that preserving uretha inner sphincter within cavity prostatic resection is effective on providing relief of bladder outlet obstruction resulted from BPH.