术前尿动力学检查对前列腺增生症术后疗效的评估研究

目的探讨前列腺增生症（BPH）患者通过术前尿动力学检查预测、评估其术后疗效不佳的原因。方法对156例BPH患者术前进行尿动力学检查,并对术后症状改善情况进行分析。结果本组中术前膀胱出口梗阻（BOO）合并膀胱逼尿肌功能损害较轻或基本正常的患者术后疗效理想,其他合并逼尿肌收缩功能障碍（IDC）的大部分患者术后1个月内恢复,排尿通畅,尿频等症状减轻或消失。术后6个月仍疗效不佳的31例患者中,术前逼尿肌不稳定（D I）6例;逼尿肌低顺应性9例;逼尿肌活动低下（DUA）13例;膀胱出口仍有梗阻3例。结论造成BPH术后疗效不佳的主要原因是与逼尿肌的功能受损有关。尿动力学检查能正确判断患者是否有BOO,还可评估膀胱逼尿肌功能,从而对BPH的治疗方案,治疗时机的选择,特别是对术后疗效的预测、评估及查明疗效不佳的原因有着重要的指导作用。

Urodynamics Analysis in Prognosticating Efficacy after Prostatectomy

Objective To evaluate the cause of urodynamic analysis in prognosticating efficacy after prostatectomy.Methods The test of urodynamics was taken for the 156 patients with benign prostate hyperplasia(BPH),and analyse the result of the symptom improvements after operation.Results In 31 cases of poor therapeutic effects at 6 months after surgery.We found that detrusor instability(DI)appeared in 6 patients,9 patients had lowcompliance bladders,13 patients had detrusor under-activity(DUA),3 patients still had bladder outlet obstruction(BOO).Conclusion The main causes affecting the prognosis of BPH patients after prostatectomy was detrusor function damage.Urodynamicsb was of important guiding function in correcting judgment whether the patients has BOO and evaluation to the detrusor dysfunction,choose the scheme of treatment and the operation time for BPH,especially in predicting effect of prostatectomy,evaluation and searching of the cause of poor therapeutic effects.