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目的:探讨60岁以上老年男性脑卒中后排尿异常的尿动力学改变。方法:选择50例脑卒中后恢复期或后遗症期排尿异常老年男性患者,其中无BPH脑卒中22例,年龄(69.25±5.78)岁;有BPH脑卒中28例,年龄(71.49±7.65)岁;另选择20例无下尿路异常的正常老年男性[(70.63±6.52)岁]作为对照组,分别进行尿动力学检查,并对各种尿动力学参数进行统计分析。结果:无BPH和有BPH脑卒中组比较,最大尿流率时逼尿肌压为(4.54±0.80)vs.(5.34±0.97)kPa(1 cmH_2O=0.098 kPa),最大尿道闭合压为(5.45±0.55)vs.(6.99±1.05)kPa,剩余尿量为(9.0±3.4)vs.(12.9±5.3)ml,差异有统计学意义(P<0.05)。与正常老年组比较,无BPH和有BPH脑卒中组逼尿肌反射亢进发生率均显著增加[72.7%(16/22)vs.75%(21/28)vs.10.0%(2/20)],其最大膀胱容量明显减少[(298.8±112.6)vs.(276.5±132.21)vs.(478.6±92.6)ml]。结论:脑卒中后排尿异常应进行尿动力学检查。有BPH脑卒中患者逼尿肌排尿压、尿道闭合压和剩余尿量变化较无BPH脑卒中患者更为明显,提示应同时治疗BPH。
Objective: To investigate the urodynamic changes of urination abnormalities after stroke in elderly men over 60 years old. Methods: Fifty elderly male patients with abnormal urination during post-stroke recovery or sequelae were selected. There were 22 BPH-free stroke patients (69.25 ± 5.78) years old, 28 BPH stroke patients (71.49 ± 7.65) years old, Another 20 normal elderly men without lower urinary tract abnormalities [(70.63 ± 6.52) years] were selected as the control group, and their urodynamic parameters were analyzed respectively. All urodynamic parameters were statistically analyzed. Results: Compared with BPH stroke group, the maximum urinary flow rate was (4.54 ± 0.80) vs. (5.34 ± 0.97) kPa (1 cmH 2 O = 0.098 kPa) and the maximum urethral closure pressure was (5.45 ± 0.55) vs (6.99 ± 1.05) kPa, and the residual urine volume was (9.0 ± 3.4) vs. (12.9 ± 5.3) ml, respectively, with statistical significance (P <0.05). The incidence of detrusor hyperreflexia was significantly increased in the BPH-free and BPH-induced stroke groups compared with the normal control group [72.7% (16/22) vs. 75% (21/28) vs. 10.0% (2/20) ], The maximum bladder capacity was significantly decreased [(298.8 ± 112.6) vs. (276.5 ± 132.21) vs. (478.6 ± 92.6) ml]. Conclusion: Post-stroke urination abnormalities should be checked by urodynamics. BPH patients with stroke detrusor voiding pressure, urethral closure pressure and residual urine volume changes than BPH patients with stroke is more obvious, suggesting that BPH should be treated at the same time.