尿流动力学检查评估老年男性急性尿潴留的临床意义

目的 探讨尿流动力学检查评估老年男性急性尿潴留（AUR）的临床价值。方法 103例老年男性AUR患者保留导尿2~5 d后接受尿流动力学检查，拔管失败者分别于AUR发生后4周和12周复查尿流动力学检查，并结合其临床资料进行分析。结果 根据初次尿流动力学检查结果，103例AUR患者分为逼尿肌活动低下组（DUA组，n=36）和非逼尿肌活动低下组（NDUA组，n=67）。DUA组患者年龄和并发症发生率显著高于NDUA组（P〈0.05，P〈0.01），两组国际前列腺症状评分（IPSS）、前列腺特异性抗原（PSA）水平和前列腺体积差异无统计学意义（P〉0.05）。该103例患者AUR发生4周时尿流动力学参数显著优于AUR发生1周内（P〈0.01或P〈0.05），但与12周时比较差异无统计学意义（P〉0.05）。结论 尿流动力学检查可有效评估AUR老年男性的膀胱功能，AUR发生4周时进行检查较为合适。

Clinical value of urodynamic examination for evaluating old male patients with acute urinary retention

Objective To investigate the clinical value of the urodynamic examination for old male patients with acute urinary retention （AUR）. Methods One hundred and three old male patients with AUR received the urodynamic examination after retention catheterization for 2-5 days. For patients failed to remove catheters, the urodynamic examination was repeated after 4 and 12 weeks of AUR occurrence and the analysis was conducted in combination with clinical data. Results According to results of the first urodynamic examination, 103 AUR patients were divided into the low detrusor activity group （DUA group, n=36） and non-low detrusor activity group （NDUA group, n=67）. The age and incidence of complications of the DUA group were significantly higher than those of the NDUA group （P〈0.05，P〈0.01）. The differences of the international prostate symptom scores （IPSS）, prostate specific antigen （PSA） levels, and prostate volumes of two groups were not statistically significant （P〉0.05）. Urodynamic parameters of 103 patients after 4 weeks of AUR occurrence were significantly better than those within 1 week of AUR occurrence （P〈0.01 or P〈0.05）. But compared to urodynamic parameters after 12 weeks of AUR occurrence, the differences were not statistically significant （P〉0.05）. Conclusion The urodynamic examination can effectively evaluate the bladder function of old male patients with AUR. The proper time for examination is after 4 weeks of AUR occurrence.