良性前列腺增生患者膀胱出口梗阻和逼尿肌功能的分析

目的：探讨尿动力学检查对BPH患者膀胱出口梗阻（BOO）和逼尿肌功能的诊断意义.方法：对95例BPH患者进行压力-容积和压力-流率测定.结果：95例BPH患者中BOO 57例,无BOO23例,其余15例为可疑或分析困难.BOO组前列腺体积大于无BOO组（62.4±16.1）cm^3 vs（41.0±7.1）cm^3（P＜0.05）,最大尿流率（Qmax）小于无BOO组（5.4±1.9）ml/s vs（12.4±5.0）ml/s（P＜0.05）,两组IPSS评分无差别（23.7±4.4）分vs（25.2±4.9）分（P＞0.05）.BOO组有逼尿肌不稳定收缩（DD34例,无BOO组D119例.结论：尿动力学检查有助于判断有无BOO存在,了解BPH患者的逼尿肌功能.IPSS不能判断患者的下尿路症状（LUTS）是否因BOO导致.BPH患者前列腺体积不足很大,但LUTS明显时,应行尿动力学检查.自由尿流率测定对BOO诊断有一定帮助.DI是无BOO患者发生LUTS的重要因素.

Analysis of Bladder Outlet Obstruction and Detrusor Function in Patients with Benign Prostatic Hyperplasia

Objective：To evaluate the diagnosis value of urodynamics to bladder outlet obstruction（BOO） and detrusor function in the patients with benign prostatic hyperplasia（BPH）. Methods： A total of 95 patients with BPH underwent filling cystometry volume and pressure flow studies. Results： Among the 95 patients, BOO was diagnosed in 57 cases and eliminated in 23 cases, other 15 cases couldn＇t be confirmed. The mean volume of prostate in the 13OO group was significantly larger than that in the no-BOO group （62.4±16. 1）cm^3 vs（41.0±7.1 ） cm^3（P〈0.05）. Additionally, the maximum flow rate（Qmax） in BOO was significantly lower than that in no-BOO （5.4±1. 9） ml/s vs（12.4 ± 5.0） ml/s （P〈0. 05）. However, there was no difference in international prostate symptom score （IPSS） in both groups （23.7±4.4） vs （25.2±4.9）（P〉0.05）. There were 34 cases with detrusor inst＆bility（DI） in the BOO group and 19 eases in the no-BOO group. Conclusions： Urodynamics can help to di agnose BOO and evaluate the detrusor function in the patients with BPH. It is difficult to confirm whether the lower urinary tract symptoms （LUTS） of BPH patients attribute to BOO through IPSS. If the prostate volume is not so large in the BPH patients with obvious LUTS, Urodynamics should be executed. The examination of flow rate is beneficial to the diagnosis of BOO. DI play an important role to the no-BOO patients with LUTS.