前列腺增生手术前后膀胱重量变化的研究

目的 探讨良性前列腺增生（BPH）经尿道前列腺切除术（TURP）手术前后膀胱重量的变化及临床意义。方法 BPH患者63例,其中术后随访资料完整者21例,以相同年龄段无下尿路症状30例男性作为对照组。经腹B超测量膀胱壁厚度并结合膀胱容量按照球形体积公式估算膀胱重量。以尿动力学检查评价膀胱出口梗阻（BOO）和膀胱功能。63例BPH患者术前膀胱重量（97±54）g,对照组为（41±14）g,膀胱重量与梗阻分级（LinPURR）呈正相关（R=0．47）,与最大尿流率（Qmax）呈负相关（R=-0．52）,与残余尿量呈正相关（R=0．48）,差异均有统计学意义（P〈0．01）,与逼尿肌收缩强度（WF）呈负相关（R=-0．40,P〈0．05）。21例患者术前B超估测膀胱重量（UEBW）（99±50）g。结果 21例患者术后UEBW为（56±21）g,与术前比较差异有统计学意义（P〈0．01）。术后UEBW平均下降43．68％,国际前列腺症状评分（IPSS）下降16．81分,Qmax平均增加8．38ml／8。结论 膀胱重量作为一项无创性检查方法,对前列腺增生症进展的监测、术前评估和术后疗效的评价具有临床应用价值。

Study on the change of bladder wall weight pre and after surgery in patients with benign prostatic hyperplasia

OBJECTIVE: To investigate the changes and its clinical significance of ultrasound evaluated bladder wall weight (UEBW) pre and after surgery in patients with benign prostatic hyperplasia (BPH). METHODS: The clinical data of 63 patients of benign prostatic hyperplasia and 30 of contrast control were studied. The bladder wall weight was calculated by subtracting the volume of sphere represented by the urine volume inside the bladder from the volume of the sphere representing the whole bladder (sphere with a radius = internal radius + bladder wall thickness). Bladder outlet obstruction (BOO) and bladder function was evaluated by urodynamic studies. Of the 63 patients with BPH, UEBW was (97 +/- 54) g, while the control group was only (41 +/- 14) g. UEBW was found to be significantly correlated with LinPURR grade (R = 0.47, P < 0.01) and postvoid residual urine volume (R = 0.48, P < 0.01), and it was negatively correlated with Qmax (R = -0.52, P < 0.01) and detrusor contraction strength (presented as WF, R = -0.4, P < 0.05). RESULTS: A significant difference was found between the UEBW pre and after surgery (99 +/- 50) g vs. (56 +/- 21) g, t = 5.05, P < 0.01)]. UEBW decreased 43.68%, and IPSS score decreased 16.81 point, while Qmax increased 8.38 ml/s. CONCLUSION: As an non-invasive methods, measurement of bladder wall weight appears to be a useful marker in evaluating status before operation and in monitoring the effection of surgery for patients with BPH.