本文選題：前列腺增生 + 尿動(dòng)力學(xué)檢查　； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：目的：回顧性分析前列腺增生患者尿動(dòng)力學(xué)檢查結(jié)果與經(jīng)尿道前列腺切除術(shù)（TURP）后療效的關(guān)系，再評(píng)估TURP術(shù)前尿流動(dòng)力學(xué)檢查的應(yīng)用價(jià)值。 方法：收集2012年1月至2013年5月在蘇州大學(xué)附屬第一醫(yī)院泌尿外科因良性前列腺增生癥（BPH）接受經(jīng)尿道前列腺切除（TURP）手術(shù)的82例患者的臨床與隨訪資料。所有患者術(shù)后的病理檢查結(jié)果為前列腺增生，，并且在術(shù)前接受了尿流動(dòng)力學(xué)檢查�；仡櫺苑治龌颊咝g(shù)前、術(shù)后3個(gè)月時(shí)的國際前列腺癥狀（IPSS）評(píng)分、生活質(zhì)量評(píng)分（QOL）、OAB-V8評(píng)分、最大尿流率（Q-max）、殘余尿量、尿流動(dòng)力學(xué)檢查各參數(shù)等，從而判斷TURP手術(shù)療效與術(shù)前尿流動(dòng)力學(xué)檢查結(jié)果間的相關(guān)性。 結(jié)果：82例TURP患者術(shù)后初次試行拔除導(dǎo)尿管（TWOC）成功率的為90.24%（74/82例）。IPPS評(píng)分明顯改善（術(shù)前19.1±5.5分Vs術(shù)后7.1±5.4分，P0.01）；QOL評(píng)分明顯改善（術(shù)前4.3±1.7分Vs術(shù)后2.1±1.5分，P0.05）。Q-max分別由術(shù)前的9.6±5.2ml/s上升到術(shù)后的17.4±4.1ml/s；殘余尿量由術(shù)前的62.2±27.8ml顯著下降到術(shù)后的23.2±11.6ml。 Q-max時(shí)逼尿肌壓力≥40cmH2O患者（共62例），術(shù)后初次TWOC成功率98.39%（61/62例），明顯高于逼尿肌壓力40cmH2O患者的65.00%（13/20例），P0.05；而且，術(shù)后主觀癥狀改善更加明顯，IPSS評(píng)分6.8±4.9分，明顯優(yōu)于40cmH2O患者的IPSS評(píng)分10.5±4.5分，P0.05。尿流動(dòng)力學(xué)檢查顯示，BPH合并OAB患者17例，發(fā)生率為20.73%（17/82例），TURP術(shù)后OAB癥狀未見明顯緩解。與TURP術(shù)前相比較，BPH合并OAB患者，OAB-V8評(píng)分分別為18.2±6.2分和15.3±5.8分，P0.05。尿動(dòng)力學(xué)檢查并發(fā)癥方面：有2例檢查術(shù)后發(fā)生菌血癥；6例發(fā)生嚴(yán)重尿頻、尿急、尿痛癥狀；5例發(fā)生肉眼血尿。 結(jié)論：1.尿動(dòng)力學(xué)檢查提示，Qmax時(shí)逼尿肌收縮力正常者，TURP術(shù)后不僅IPSS評(píng)分顯著改善，而且初次TWOC成功率高。2. TURP手術(shù)并不能改善BPH患者的OAB癥狀，術(shù)前通過尿動(dòng)力學(xué)檢查發(fā)現(xiàn)并控制好OAB癥狀后再手術(shù)，效果更好。3.尿動(dòng)力學(xué)檢查可能引起嚴(yán)重并發(fā)癥，應(yīng)謹(jǐn)慎選擇，同時(shí)積極對(duì)癥處理產(chǎn)生的并發(fā)癥。
[Abstract]:Objective: to retrospectively analyze the relationship between the results of urodynamic examination and the curative effect after transurethral prostatectomy (TURP) in patients with benign prostatic hyperplasia (BPH), and to evaluate the value of urodynamic examination before TURP. Methods: from January 2012 to May 2013, 82 patients undergoing transurethral prostatectomy (TURP) in Urology Department of the first affiliated Hospital of Suzhou University were treated with transurethral prostatectomy (TURP). All patients had benign prostatic hyperplasia (BPH) and underwent urodynamic examination before operation. The International Prostate symptom (IPSS) score, quality of Life score (QOL), OAB-V8 score, maximum flow rate (Q-max), residual urine volume, urodynamic parameters were retrospectively analyzed. Therefore, the correlation between the curative effect of TURP and the results of urodynamic examination before operation was evaluated. Results the successful rate of the first trial removal of urethral catheter (TWOC) in 82 TURP patients was 90.24% (74 / 82). IPPS score was improved significantly (preoperative 19.1 鹵5.5 vs 7.1 鹵5.4 vs P0.01). QOL scores improved significantly (preoperative 4.3 鹵1.7 vs 2.1 鹵1.5 vs P0.05) .Q-max increased from 9.6 鹵5.2ml/s to 17.4 鹵4.1 ml / s, and residual urine volume decreased significantly from 62.2 鹵27.8ml to 23.2 鹵11.6 ml. In 62 patients with detrusor pressure 鈮

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