發(fā)布時(shí)間：2018-01-17 15:37

  本文關(guān)鍵詞：逼尿肌功能狀態(tài)與經(jīng)尿道前列腺等離子電切術(shù)后膀胱痙攣的相關(guān)性研究　出處：《青海大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 逼尿肌不穩(wěn)定 前列腺增生 經(jīng)尿道前列腺切除術(shù) 膀胱痙攣

【摘要】：目的:探討并研究前列腺增生(Benign prostatic hyperplasia,BPH)患者逼尿肌功能狀態(tài)與術(shù)后發(fā)生膀胱痙攣的相關(guān)性,從而于術(shù)前一定程度上預(yù)測(cè)及評(píng)估術(shù)后膀胱痙攣的發(fā)生及其嚴(yán)重程度,減少臨床治療的盲目性,為術(shù)后預(yù)防其發(fā)生提供理論依據(jù),使患者從手術(shù)中最大程度獲益。方法:收集青海大學(xué)附屬醫(yī)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,入院后均行經(jīng)尿道前列腺等離子切除術(shù)(Transurethral plasmakinetic resection prostate,TUPKRP),并且術(shù)后均經(jīng)過組織病理學(xué)檢查確認(rèn)為良性前列腺增生。根據(jù)2014版的《良性前列腺增生診斷治療指南》中可選擇檢查項(xiàng)目尿流動(dòng)力學(xué)檢查結(jié)果,按照是否存在膀胱逼尿肌不穩(wěn)定(Detrusor instability,DI)狀態(tài)分為A、B兩組,A組(試驗(yàn)組)為膀胱逼尿肌不穩(wěn)定組(DI組),B組(對(duì)照組)為膀胱逼尿肌穩(wěn)定(Detrusor stability,DS)組(DS組),整理記錄兩組患者的一般情況如年齡、國(guó)際前列腺癥狀評(píng)分(International prostate symptom score,IPSS)、最大尿流率(Maximum flow rate,Qmax)、術(shù)后尿管留置時(shí)間、手術(shù)時(shí)間、膀胱沖洗時(shí)間等,觀察并記錄兩組患者術(shù)后至導(dǎo)尿管拔出期間膀胱痙攣發(fā)生的次數(shù)、發(fā)生率及嚴(yán)重程度,并通過統(tǒng)計(jì)學(xué)方法對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,得出結(jié)論。結(jié)果:DI組術(shù)后膀胱痙攣發(fā)生率77.78%,DS組發(fā)生率53.06%,DI組術(shù)后膀胱痙攣發(fā)生率較高,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。在術(shù)后膀胱痙攣發(fā)生次數(shù)方面,DI組顯著高于DS組,兩組差異存在統(tǒng)計(jì)學(xué)意義(P0.05)。針對(duì)術(shù)后膀胱痙攣嚴(yán)重程度評(píng)分,DS組評(píng)分較低,與DI組相比較,具有顯著性的差異(P0.05)。結(jié)論:BPH患者術(shù)前逼尿肌功能狀態(tài)與TUPKRP術(shù)后膀胱痙攣的發(fā)生存在一定的相關(guān)性,DI組患者術(shù)后更容易發(fā)生膀胱痙攣,不僅發(fā)生率較高且程度更為嚴(yán)重。因此臨床上可以通過術(shù)前尿流動(dòng)力學(xué)檢查來了解逼尿肌功能狀況,并特別注意那些存在逼尿肌不穩(wěn)定的BPH患者,強(qiáng)調(diào)術(shù)后給予預(yù)防措施干預(yù),避免或減少術(shù)后膀胱痙攣的發(fā)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.

【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R699.8

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