摘要
目的探讨改良尿道扩张术治疗女性膀胱颈梗阻的效果。方法回顾性分析2015年3月至2020年3月在青岛市第三人民医院行改良尿道扩张术治疗的女性膀胱颈梗阻患者33例的临床资料,治疗前进行体检、尿常规检查、国际前列腺症状评分(IPSS)、超声检查、尿动力学检查及膀胱尿道镜检查以明确诊断,均行α受体阻滞剂治疗3个月以上而无明显效果,在局部麻醉下行改良尿道扩张术,治疗结束后3个月行IPSS评分、尿动力学检查测残余尿量、最大尿流率(Qmax)、膀胱最大逼尿肌压力(Pdet.Qmax)进行疗效评估。结果33例患者治疗后,25例患者诉排尿困难症状较前明显缓解,8例症状改善不明显,拟行经尿道膀胱颈切开术。治疗后IPSS评分为(15.18±6.19)分,显著低于治疗前的(24.86±7.26)分(t=3.782,P<0.001);治疗后膀胱残余尿量[(53.69±48.35)mL]较治疗前[(181.45±92.15)mL]明显减少(t=15.328,P<0.001);治疗后Qmax[(16.21±4.22)mL/s]明显高于治疗前[(7.91±1.69)mL/s](t=6.358,P<0.001);治疗后Pdet.Qmax[(27.38±5.13)cmH2O]较治疗前[(57.15±8.43)cmH2O]明显下降(t=9.584,P<0.001),差异均有统计学意义。结论改良尿道扩张术是一种治疗女性膀胱颈梗阻有效方法,可作为手术治疗的补充。
Objective To investigate the efficacy of modified urethral dilatation in the treatment of female bladder neck obstruction.Methods The clinical data of 33 female patients with bladder neck obstruction who underwent modified urethral dilatation in the Third People's Hospital of Qingdao from March 2015 to March 2020 were retrospectively analyzed.Before treatment,physical examination,routine urine examination,International Prostate Symptom Score,ultrasound examination,urodynamic examination and cystourethroscopy were performed to confirm the diagnosis.All patients were treated withα-blocker for more than 3 months,but obvious effect was not obtained.Under local anesthesia,they underwent modified urethral dilatation.After 3 months of treatment,International Prostate Symptom Score and urodynamic examination were performed to determine residual urine volume,the maximum urinary flow rate,and detrusor pressure at the maximum urinary flow rate.The curative effects of modified urethral dilatation were evaluated.Results After modified urethral dilatation,dysuria was obviously alleviated in 25 patients.Eight patients who had no obvious improvement in dysuria were scheduled to undergo transurethral bladder neck incision.International Prostate Symptom Score after treatment was significantly lower than that before treatment[(15.18±6.19)vs.(24.86±7.26),t=3.782,P<0.001).Residual urine volume after treatment was significantly smaller than that before treatment[(53.69±48.35)mL vs.(181.45±92.15)mL,t=15.328,P<0.001].The maximum urinary flow rate after treatment was significantly higher than that before treatment[(16.21±4.22)mL/s vs.(7.91±1.69)mL/s],t=6.358,P<0.001].Detrusor pressure at the maximum urinary flow rate after treatment was significantly lower than that before treatment[(27.38±5.13)cmH2O vs.(57.15±8.43)cmH2O,t=9.584,P<0.001].Conclusion Modified urethral dilatation is an effective treatment method of female bladder neck obstruction.It can be used as a supplement for surgical treatment.
作者
孙延波
李奎
Sun Yanbo;Li Kui(Department of Urology,the Third People's Hospital of Qingdao,Qingdao 266000,Shandong Province,China;Department of Urology,the Affiliated Hospital of Qingdao Binhai University(Qingdao Military-civil Integration Hospital),Qingdao 266000,Shandong Province,China)
出处
《中国基层医药》
CAS
2021年第3期385-388,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
膀胱颈梗阻
排尿动力学
排尿障碍
残余尿
尿道扩张术
女性
Urinary bladder neck obstruction
Urodynamics
Urination disorders
Residual urine
Modified urethral dilatation
Female
作者简介
通信作者:李奎,Email:lllcc0326@163.com,电话:0532-58788291。
