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目的:通过对良性前列腺增生(BPH)患者经耻骨上膀胱造瘘与经尿道置管两种方法行排尿期压力-流率测定的结果比较,探讨应用前者的必要性。方法:对23例平均年龄为69.3(57~77)岁的患者同时以经耻骨上膀胱造瘘与经尿道置管两种方法行排尿期压力-流率测定,对相应参数以配对t检验进行统计比较。结果:①经耻骨上膀胱造瘘与经尿道置管相比,最大尿流率(Qmax)提高约1.19 ml/s(P<0.05);最大尿流率时逼尿肌压力(Pdet,Qmax)减少约10.57 cmH2O(P<0.05);组特异性尿道阻力因子(URA)减少约11.39 cmH2O(P<0.01);AG(Pdet,Qmax-2Qmax)数减小约12.94(P<0.01);最大膀胱容量增加约66.61 ml(P<0.01)。②分别以schafer图所示、AG数>40为判定梗阻的标准,经耻骨上膀胱造瘘的梗阻数均为16(69.6%),而以尿道置测压管均为20(87.0%),前者例数比后者减少。结论:行排尿期压力-流率测定时,经耻骨上膀胱造瘘与经尿道置管两种方法各有利弊,对BPH患者,主张选择前者。对于其它疾病患者应视具体情况而定。
Objective: To explore the necessity of applying the former by comparing the urinary pressure-flow rate measurement in two methods of suprapubic cystostomy and transurethral catheterization in patients with benign prostatic hyperplasia (BPH). Methods: Twenty-three patients with mean age of 69.3 (57-77) years of age were treated with both suprapubic cystostomy and transurethral catheterization. The urinary pressure-flow rate was measured and paired t test was performed on the corresponding parameters Statistics comparison. Results: ① The maximal urinary flow rate (Qmax) increased by about 1.19 ml / s (P <0.05) compared with transurethral catheterization through the suprapubic cystostomy. The detrusor pressure (Pdet, Qmax) (P <0.05); The specific urethral resistance factor (URA) decreased by about 11.39 cmH2O (P <0.01); the number of Pdet and Qmax-2Qmax decreased by about 12.94 The capacity increased by about 66.61 ml (P <0.01). (2) As shown in the schafer chart, the number of AG> 40 was the criterion for determining obstruction. The number of obstruction on the suprapubic cystostomy was 16 (69.6%), while that on the urethra was 20 (87.0% The former is less than the latter. Conclusion: There are pros and cons of transurethral cystostomy and transurethral catheterization in urinary pressure-flow rate measurement. For BPH patients, the former is the preferred choice. For other diseases patients should be specific circumstances.