摘要
目的报道女性原发性膀胱颈梗阻并发腹痛的诊疗体会。方法 2001年5月～2008年12月收治13例女性原发性膀胱颈梗阻并发腹痛患者,经常规尿动力学结合膀胱尿道造影诊断本病,均经α1-受体拮抗剂治疗无效后接受经尿道膀胱颈电切术(TURBN)治疗。比较手术前后最大尿流率、最大尿流率时逼尿肌压力I、PSS评分、排尿症状生活质量评分,评估TURBN的疗效。结果术后1例失访,随访12例,3～24个月,其中10例随访尿动力学I、PSS评分及排尿症状生活质量评分;2例仅随访IPSS评分及排尿症状生活质量评分。10例患者手术前后比较尿动力学指标,最大尿流率分别为(8.00±1.944)mL/s及(12.70±3.129)mL/s(P<0.01),最大尿流率时逼尿肌压力(6.70±2.497)kPa及(5.64±2.237)kPa(P<0.01)。12例患者手术前后IPSS评分分别为(15.92±5.42)及(10.42±6.07)分(P<0.01);排尿症状生活质量评分分别为(5.17±0.84)及(2.33±1.07)分(P<0.01)。结论在排除泌尿系结石、胃肠疾病等以后,经常规尿动力学结合膀胱尿道造影可诊断本病。对经α1-受体拮抗剂治疗无效的患者,TURBN是治疗女性原发性膀胱颈梗阻并发腹痛的安全、有效手段。
Objective To present experience on the diagnosis and treatment of female primary bladder neck obstruction（PBNO） with bellyache. Methods Clinical data are collected from 13 female patients with diagnosis of PBNO with bellyache from May 2001 to December 2008.All of these patients were identified by conventional urodynamics combined with cysto-urethrogaphy.After conservative treatment with the oral α1-receptor blocker failed,all patients accepted TURBN treatment.To value therapeutic effectiveness of TURBN for PBNO with bellyache,the dynamic parameters,such as preoperative and postoperative detrusor pressure at maximum flow,maximum flow rate,IPSS scores and quality of life scores,are compared and analyzed. Results One patient was lost to follow up,the 12 patients were followed up for 3 to 24 months. The follow-up evaluation in 10 cases included urodynamics,IPSS scores and quality of life scores while that in another 2 cases included only IPSS scores and quality of life scores. The preoperative and postoperative Qmax values in the 10 patients were （8.00 ± 1.944）mL/s and（12.70±3.129）mL/s（P〈0.01）. And Pdet-Qmax values were（6.70±2.497） kPa and（5.64±2.237） kPa（P〈0.01）. IPSS scores in the pre-and post-operation of 12 patients were （15.92 -＋5.42） and （10.42±6.07） （P〈0.01）. Quality of life scores were（5.17±0.84） and（2.33±1.07）（P〈0.01）. Conclusion Excluding urinary calculous or gut disease,combined urodynamics with cysto-urethrogaphy is an TURBN is safe and effective measure for female PBNO with effective and accurate diagnostic way for female PBNO with bellyache bellyache refractory to previous α1-receptor blocker medication.
出处
《中国现代医生》
2011年第5期25-27,共3页
China Modern Doctor
关键词
女性
原发性膀胱颈梗阻
腹痛
诊断
治疗
Female
Primary bladder neck obstruction
Bellyache
Diagnosis
Treatment
