逼尿肌功能状态与经尿道前列腺等离子电切术后膀胱痉挛的相关性研究

发布时间：2018-01-17 15:37

本文关键词：逼尿肌功能状态与经尿道前列腺等离子电切术后膀胱痉挛的相关性研究　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨并研究前列腺增生(Benign prostatic hyperplasia,BPH)患者逼尿肌功能状态与术后发生膀胱痉挛的相关性,从而于术前一定程度上预测及评估术后膀胱痉挛的发生及其严重程度,减少临床治疗的盲目性,为术后预防其发生提供理论依据,使患者从手术中最大程度获益。方法:收集青海大学附属医院泌尿外科2015年11月至2016年12月收治的良性前列腺增生患者103例,入院后均行经尿道前列腺等离子切除术(Transurethral plasmakinetic resection prostate,TUPKRP),并且术后均经过组织病理学检查确认为良性前列腺增生。根据2014版的《良性前列腺增生诊断治疗指南》中可选择检查项目尿流动力学检查结果,按照是否存在膀胱逼尿肌不稳定(Detrusor instability,DI)状态分为A、B两组,A组(试验组)为膀胱逼尿肌不稳定组(DI组),B组(对照组)为膀胱逼尿肌稳定(Detrusor stability,DS)组(DS组),整理记录两组患者的一般情况如年龄、国际前列腺症状评分(International prostate symptom score,IPSS)、最大尿流率(Maximum flow rate,Qmax)、术后尿管留置时间、手术时间、膀胱冲洗时间等,观察并记录两组患者术后至导尿管拔出期间膀胱痉挛发生的次数、发生率及严重程度,并通过统计学方法对数据进行统计学分析,得出结论。结果:DI组术后膀胱痉挛发生率77.78%,DS组发生率53.06%,DI组术后膀胱痉挛发生率较高,两组间差异有统计学意义(P0.05)。在术后膀胱痉挛发生次数方面,DI组显著高于DS组,两组差异存在统计学意义(P0.05)。针对术后膀胱痉挛严重程度评分,DS组评分较低,与DI组相比较,具有显著性的差异(P0.05)。结论:BPH患者术前逼尿肌功能状态与TUPKRP术后膀胱痉挛的发生存在一定的相关性,DI组患者术后更容易发生膀胱痉挛,不仅发生率较高且程度更为严重。因此临床上可以通过术前尿流动力学检查来了解逼尿肌功能状况,并特别注意那些存在逼尿肌不稳定的BPH患者,强调术后给予预防措施干预,避免或减少术后膀胱痉挛的发生。
[Abstract]:Objective: To investigate and study of benign prostatic hyperplasia (Benign prostatic, hyperplasia, BPH) correlation between bladder spasm and detrusor function in patients after operation, and to a certain extent preoperative prediction and evaluation of bladder spasm after surgery and its severity, reduce the blindness of clinical treatment and provide a theoretical basis for the prevention of postoperative. The maximum benefit from surgery patients. Methods: 103 patients with benign prostatic hyperplasia in the Department of Urology of Affiliated Hospital of Qinghai University from November 2015 to December 2016 were collected the cases were treated with transurethral resection of prostate plasma (Transurethral plasmakinetic resection prostate, TUPKRP), and postoperative after histopathological examination confirmed as benign prostatic hyperplasia. According to the diagnosis and treatment of hyperplasia choose to check the project urine flow mechanics check nodes can be in the "guidelines for the 2014 edition of the" benign prostate Fruit, according to the existence of bladder detrusor instability (Detrusor instability DI) state is divided into A, B two groups, A group (experimental group) for bladder detrusor instability group (DI group), B group (control group) for bladder detrusor stability (Detrusor stability, DS) group (group DS), finishing record the general situation of the two groups of patients such as age, International Prostate Symptom Score (International prostate, symptom score, IPSS), maximum urinary flow rate (Maximum flow, rate, Qmax), catheter indwelling time, postoperative operation time, bladder irrigation time, observe and record the two groups of patients after catheter to pull out the frequency of bladder spasm during the occurrence, incidence and severity, and the data were statistically analyzed and concluded by statistical methods. Results: in group DI, postoperative bladder spasm was 77.78%, DS group was 53.06%, DI group of postoperative bladder spasm was higher, there is statistical difference between the two groups. Significance (P0.05). The postoperative bladder spasm times, DI group was significantly higher than that of DS group, there was significant difference between two groups (P0.05). The postoperative bladder spasm severity score, the score of group DS was lower, compared with the DI group, the difference was significant (P0.05). Conclusion: there is a correlation between the occurrence of BPH in patients with preoperative and postoperative TUPKRP detrusor function of bladder spasm, DI group patients were more prone to bladder spasm, not only a higher incidence and more serious. Therefore, to understand the clinical status of detrusor function through preoperative urodynamic examination, and pay special attention to the existence of detrusor no patients with stable BPH, emphasis on prevention intervention after the surgery, avoid or reduce the occurrence of bladder spasm after operation.

【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R699.8

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