CAJ | 학술논문

目的研究B超发现有膀胱小梁形成BPH患者临床及尿流动力学特点,探讨其作为BPH外科干预指征的意义.方法比较B超显示有膀胱小梁形成BPH患者与无膀胱小梁形成BPH患者的临床资料及尿流动力学检查结果.结果56例B超发现有膀胱小梁形成BPH患者与106例无膀胱小梁形成BPH患者比较,平均年龄分别为(72.9±11.2)岁和(68.2±6.4)岁,国际前列腺症状评分(international prostate symptom score, IPSS)分别为(23.8±6.4)分和(22.5±7.9)分,均无明显差别(P>0.05).有小梁形成患者和无小梁形成患者,最大尿流率时逼尿肌压力分别为(134.6±59.2)cmH2O(1 cmH2O=0.098kPa)和(93.3±45.4) cmH2O,线性被动尿道阻力关系(linearized passive urethral resistance relation,LinPURR)梗阻程度分级分别为(4.6±1.3)和(3.6±1.6),差异有统计学意义(P<0.05).有小梁形成组逼尿肌过度活动(detrusor overactive, DO)患者所占比例为73.2%,无小梁形成组为56.6%(P=0.038);小梁形成组71.4%的患者膀胱顺应性减低,16.1%出现肾积水,无小梁形成组分别为44.7%、4.7%(P值分别为0.001和0.014).肾积水患者均存在肾功能不全,平均肌酐水平149μmol/L.结论膀胱小梁形成是膀胱代偿功能的一种表现;其中多数患者处于由代偿期向失代偿期过渡的阶段;有膀胱小梁形成的BPH患者上尿路积水风险明显升高;以B超发现膀胱小梁形成作为BPH患者外科干预指征,有利于膀胱功能恢复,降低上尿路积水及肾功能损害风险.
목적연구B초발현유방광소량형성BPH환자림상급뇨류동역학특점,탐토기작위BPH외과간예지정적의의.방법비교B초현시유방광소량형성BPH환자여무방광소량형성BPH환자적림상자료급뇨류동역학검사결과.결과56례B초발현유방광소량형성BPH환자여106례무방광소량형성BPH환자비교,평균년령분별위(72.9±11.2)세화(68.2±6.4)세,국제전렬선증상평분(international prostate symptom score, IPSS)분별위(23.8±6.4)분화(22.5±7.9)분,균무명현차별(P>0.05).유소량형성환자화무소량형성환자,최대뇨류솔시핍뇨기압력분별위(134.6±59.2)cmH2O(1 cmH2O=0.098kPa)화(93.3±45.4) cmH2O,선성피동뇨도조력관계(linearized passive urethral resistance relation,LinPURR)경조정도분급분별위(4.6±1.3)화(3.6±1.6),차이유통계학의의(P<0.05).유소량형성조핍뇨기과도활동(detrusor overactive, DO)환자소점비례위73.2%,무소량형성조위56.6%(P=0.038);소량형성조71.4%적환자방광순응성감저,16.1%출현신적수,무소량형성조분별위44.7%、4.7%(P치분별위0.001화0.014).신적수환자균존재신공능불전,평균기항수평149μmol/L.결론방광소량형성시방광대상공능적일충표현;기중다수환자처우유대상기향실대상기과도적계단;유방광소량형성적BPH환자상뇨로적수풍험명현승고;이B초발현방광소량형성작위BPH환자외과간예지정,유리우방광공능회복,강저상뇨로적수급신공능손해풍험.
@@@@Objective To investigate the clinical and urodynamic characters of benign prostatic hyperplasia(BPH) patients with bladder trabeculation formation and evaluate if it can be as a surgery indication for BPH patients. Methods:Clinical and urodynamic characters of BPH patients with or without bladder trabeculation formation were comparatively analyzed, retrospectively. Results Total of 56 BPH patients with bladder trabeculation and 106 BPH patients without it were comparatively analzyed. The mean age was(72.9±11.2) years old and (68.2±6.4)years old , IPSS was (23.8±6.4)and (22.5±7.9) respectively, in which no significant differences were found(P>0.05). The detrusor pressure at the maximum flow rate was (134.6±59.2) cmH2O and (93.3±45.4) cmH2O and linearized passive urethral resistance relation (LinPURR) was (4.6±1.3) and (3.6±1.6), in which significant differences were found (P<0.05). The incidence of DO in trabeculation positive and negative group was 73.2%and 56.6%respectively ( P=0.038). 71.4%of the patients with bladder trabeculation had a low compliance bladder, 16.1%had hydronephrosis and the proportion of the patients without trabeculation was 44.7%and 4.7%respectively (P=0.001 and 0.014). All of the patients with hydronephrosis had renal insufficiency. Conclusion Bladder trabeculation was the manifestation of compensation of BOO. Most of the patients with trabeculaiton were in the transition period and had higher risk for hydronephrosis. Bladder trabeculation formation as a surgery indication might be important for protecting bladder function and reducing the risk of renal insufficiency for BPH patients.