CAJ | 학술논문

目的：探讨尿动力学联合经直肠超声检查在良性前列腺增生症患者术前评估中的应用价值。方法选择150例良性前列腺增生症患者作为研究对象，术前行尿动力学及经直肠超声检查，根据是否明确膀胱出口梗阻（ VOO+）及测得前列腺体积决定是否进行手术以及选择手术方式，术后1个月复查尿动力学检查评估尿道及膀胱功能。结果根据尿动力检查有明确膀胱出口梗阻（VOO +）者129例、可疑膀胱出口梗阻（VOO +-）者17例、无膀胱出口梗阻（VOO -）者4例，三组患者在最大尿流率（Qmax）、残余尿量（PVR）、最大尿流率时逼尿肌压（Pdet - Qmax）比较差异均有统计学意义（ P <0.05）。对21例 VOO +-和 VOO -者采取保守治疗，21例前列腺体积≥80 ml 的 VOO +患者选择耻骨上膀胱切开前列腺摘除术治疗，106例前列腺体积<80 ml 的 VOO +患者选择行经尿道前列腺电切术治疗，术后1个月 Qmax、PVR、Pdet - Qmax 均较术前明显改善（ P <0.05）。结论术前常规行尿动力学联合经直肠超声检查有助于评估患者整个尿路及前列腺情况，并依据评估结果选择相应的治疗方法及手术方式。
목적：탐토뇨동역학연합경직장초성검사재량성전렬선증생증환자술전평고중적응용개치。방법선택150례량성전렬선증생증환자작위연구대상，술전행뇨동역학급경직장초성검사，근거시부명학방광출구경조（ VOO+）급측득전렬선체적결정시부진행수술이급선택수술방식，술후1개월복사뇨동역학검사평고뇨도급방광공능。결과근거뇨동력검사유명학방광출구경조（VOO +）자129례、가의방광출구경조（VOO +-）자17례、무방광출구경조（VOO -）자4례，삼조환자재최대뇨류솔（Qmax）、잔여뇨량（PVR）、최대뇨류솔시핍뇨기압（Pdet - Qmax）비교차이균유통계학의의（ P <0.05）。대21례 VOO +-화 VOO -자채취보수치료，21례전렬선체적≥80 ml 적 VOO +환자선택치골상방광절개전렬선적제술치료，106례전렬선체적<80 ml 적 VOO +환자선택행경뇨도전렬선전절술치료，술후1개월 Qmax、PVR、Pdet - Qmax 균교술전명현개선（ P <0.05）。결론술전상규행뇨동역학연합경직장초성검사유조우평고환자정개뇨로급전렬선정황，병의거평고결과선택상응적치료방법급수술방식。
Objective To investigate the application of urodynamic examination combined with transrectal ultrasound to preoperative eval-uation in benign prostatic hyperplasia. Methods 150 cases of benign prostatic hyperplasia were selected as investigated subject. All cases re-ceived urodynamic examination combined with transrectal ultrasound,and decided to operate or select operation method according to bladder outlet obstruction and prostate volume. The function of urethra and bladder were assessed to review urodynamic after a month. Results According to urodynamic examination,the bladder outlet obstruction cleat(VOO + )were in 129 cases,be suspicious bladder outlet obstruction(VOO + - ) were in 17 cases,and no bladder outlet obstruction(VOO - )were in 4 cases. There were significant difference in Qmax,PVR,Pdet - Qmax a-mong 3 group( P < 0. 05). 21 cases of VOO + and VOO - received conservative treatment,21 cases of VOO + with prostate volume ≥80 ml were selection supra - pubis incision prostatectomy,106 cases of VOO + with prostate volume < 80 ml were treat for TURP. After a month,Qmax, PVR and Pdet - Qmax were significantly improve than preoperative( P < 0. 05). Conclusion Urodynamic routine preoperative combined with transrectal ultrasonography can help evaluation the urinary tract and prostate conditions,and based on the assessment results to select the appropri-ate treatment and surgical method.