摘要
目的 分析良性前列腺增生 (BPH)患者出现肾积水的尿动力学机制。 方法 116例膀胱出口梗阻≥Ⅲ度的BPH患者分为 2组 ,无肾积水者 98例为甲组 ,行普通尿动力学检查 ;有肾积水者 18例为乙组 ,行影像尿动力学检查。对两组检查结果进行比较分析。 结果 甲乙两组的年龄分别为 (6 8.3± 6 .8)岁和 (70 .4± 7.8)岁。甲组梗阻度为Ⅲ、Ⅳ、Ⅴ、Ⅵ度者分别为 2 6、2 9、2 1、2 2例 ,乙组分别为 3、4、4、7例 ;两组的剩余尿量分别为 (10 1± 143)ml和 (2 43± 2 14)ml;不稳定性膀胱患者甲组为 34例 (35 % ) ,乙组为 8例 (4 4% ) ;顺应性差者甲组为 11例 (11% ) ,乙组为 16例 (89% )。所有 18例有肾积水的患者行影像尿动力学检查 ,无 1例出现膀胱输尿管返流。Logistic逐步回归统计发现 ,膀胱顺应性下降为唯一筛选出的危险因素 (P <0 .0 0 1)。 结论 BPH患者膀胱顺应性下降是导致肾积水的最重要危险因素 ,而患者的年龄、梗阻程度、剩余尿量、是否合并有不稳定膀胱以及有无膀胱输尿管返流与肾积水的出现无密切关系。
Objective To clarify the urodynamic mechanism of hydronephrosis due to BPH. Methods From Jan.1998 to Dec.1999 116 patients with BPH whose degree of obstruction was three or more were evaluated.Pressure-Flow micturition studies were undertaken in 98 patients without hydronephrosis (group A); while Video-urodynamics were undertaken in the other 18 with hydronephrosis (group B). Results The average age of group A was ( 68.3± 6.8) years old, group B being ( 70.4± 7.8); The obstruction was Ⅲ degree in 26、Ⅳ in 29、Ⅴ in 21 and Ⅵ in 22 in the 98 patients, while it was Ⅲ in 3、Ⅳ in 4、Ⅴ in 4 and Ⅵ in 7 in the 18 with hydronephrosis;the average residual urine were (101±143)ml versus (243±214)ml. There were 34 unstable bladders (35%) in group A versus 8(44%) in group B; Poorly compliant bladders was found in 11(11%) of group A versus 16(89%);in group B.Vesico-ureteric reflux didn't occur in all the 18 patients with hydronephrosis . With logistic regression, the poorly compliant bladders was the only selected risk factor for hydronephrosis. Conclusions Low bladder compliance in a BPH patient is the cardinal risk factor for hydronephrosis,whereas patient's age, obstruction degree, residual urine, unstable bladder and vesico-ureteric reflux have not much correlation with hydronephrosis.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2001年第5期296-298,共3页
Chinese Journal of Urology
关键词
前列腺增生症
肾积水
尿动力学
Prostatic hypertrophy
Hydronephrosis
Urodynamics
