摘要
目的探讨术前尿动力学检查对于前列腺增生合并糖尿病患者的应用价值。方法回顾性分析2015年4月~2019年5月62例伴有糖尿病的前列腺增生拟行前列腺手术患者资料,术前均行尿动力学检查,根据尿动力学检查结果,选择手术治疗或保守治疗。结果29例(46.8%)通过尿动力学检查进行补充诊断,其中14例(22.6%)因尿动力学检查结果而改变原定前列腺切除手术方案,包括8例伴有糖尿病神经源性膀胱,4例改为耻骨上膀胱造瘘,2例留置导尿,2例间歇导尿;3例逼尿肌收缩力减弱,2例改为间歇导尿,1例改为保守药物治疗;3例伴不稳定膀胱,保守药物治疗。其余15例行前列腺手术,术后留置膀胱造瘘或给予药物治疗。结论前列腺增生合并糖尿病患者行前列腺手术前应行尿动力学检查,以指导治疗方案选择。
Objective To explore the application value of preoperative urodynamic examination for benign prostatic hyperplasia(BPH)patients with diabetes mellitus(DM).Methods From April 2015 to May 2019,62 patients clinically diagnosed with BPH with DM who planned to receive prostate surgery were retrospectively analyzed.All the patients underwent urodynamic examination before surgery.According to the results of urodynamic examination,surgical treatment or conservative treatment were selected.Results Clinical diagnosis revision after urodynamic study was found in 46.8%(29/62)of patients.Rather than the initial treatment strategy of prostatectomy,14 patients(22.6%)were managed with other types of surgery or conservative treatment according to the urodynamic results.Among them,8 were diagnosed as diabetic neurogenic bladder(DNB),4 of which received suprapubic cystostomy,2 received indwelling catheterization,and 2 intermittent urinary catheterization.Three patients were diagnosed as detrusor underactivity,2 of which received intermittent urinary catheterization and 1 medical treatment.Three patients were diagnosed as unstable bladder and were treated through medical conservatively.The remaining 15 patients received initially planned prostatectomy followed by postoperative indwelling bladder fistula or medical treatment.Conclusion Preoperative urodynamic study should be performed in BPH patients with DM to direct diagnosis and management.
作者
王东耀
李文华
张福庆
丁峰
杨光
徐良
马潞林
Wang Dongyao;Li Wenhua;Zhang Fuqing(Department of Urology, Aviation General Hospital, Beijing 100012, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2020年第6期515-519,共5页
Chinese Journal of Minimally Invasive Surgery
关键词
尿动力学检查
前列腺增生症
糖尿病
术前检查
Urodynamics examination
Benign prostatic hyperplasia
Diabetes mellitus
Preoperative examination
