前列腺增生伴逼尿肌无力患者电切术治疗后的临床分析

目的 探讨良性前列腺增生（BPH）膀胱出口梗阻（BOO）致膀胱逼尿肌收缩功能无力（DU）患者的临床诊断及治疗方式.方法 2006年1月至2010年12月经治的60例BPH老年患者,均行经尿道前列腺电切术（TURP）.根据逼尿肌收缩压力（Pdet）分为4组：A组逼尿肌正常组（Pdet＞ 40 cm H2O）,B组逼尿肌无力组（Pdet＜40 cm H2O）,再将B组细分为：B1组（轻度逼尿肌无力组）（20 cm H2O ＜Pdet＜40 cm H2O）及B2组（重度逼尿肌无力组）（Pdet＜20 cm H2O）,分别对其术后的排尿症状进行了2～6年的随访.结果 统计学比较术后A、B组间及B1、B2组间的生活质量评分（QOL）、排尿梗阻症状及刺激症状,差异无统计学意义（P＞0.05）.结论 BPH患者BOO解除后,逼尿肌功能状态可能并不影响下尿路症状（LUTs）的改善.因此对BPH合并DU的患者进行必要的沟通后行手术治疗解除梗阻,可改善患者生活质量.

Clinical analysis of transurethral resection of the prostate in patients with benign prostatic hyperplasia and detrusor underactivity

Objective To investigate the diagnosis and treatment procedures of detrusor underactivity（DU） caused by bladder outlet obstruction （BOO）in patient of benign prostatic hyperplasia （BPH）.Methods A total of sixty BPH patients underwent transurethral resection of the prostate （TURP） from Jan.2006 to Dec.2010 in the study.The patients were divided into four groups according to the detrusor pressure（P-det）：Group A indicated normal detrusor contractility （P-det ＞ 40 cmH2O） ; Group B indicated DU（P-det ＜40 cm H2O） ;The Group B were divided into Group B1 of mild DU（20 cm H2O ＜ Pdet ＜40cm H2O） and Group B2 of severe DU（P-det ＜20cmH2O）.All of them were followed up 2 ～6 years after operation.Results The quality of life index （Qol）,obstructive symptoms and stimulate symptoms were compared between the groups.There was no statistically significant difference （P ＞ 0.05）.Conclusion After the release of BOO by the operation,the improvement of lower urinary tract symptoms （LUTs） has no significant correlation with detrusor function.After necessary communications with BPH patients with DU,the removement of obstruction may improve the quality of life.