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目的探讨良性前列腺增生(BPH)经尿道前列腺切除术(TURP)手术前后膀胱重量的变化及临床意义。方法 BPH 患者63例,其中术后随访资料完整者21例,以相同年龄段无下尿路症状30例男性作为对照组。经腹 B 超测量膀胱壁厚度并结合膀胱容量按照球形体积公式估算膀胱重量。以尿动力学检查评价膀胱出口梗阻(BOO)和膀胱功能。63例 BPH 患者术前膀胱重量(97±54)g,对照组为(41±14)g,膀胱重量与梗阻分级(LinPURR)呈正相关(R=0.47),与最大尿流率(Qmax)呈负相关(R=-0.52),与残余尿量呈正相关(R=0.48),差异均有统计学意义(P<0.01),与逼尿肌收缩强度(WF)呈负相关(R=-0.40,P<0.05)。21例患者术前 B 超估测膀胱重量(UEBW)(99±50)g。结果 21例患者术后 UEBW 为(56±21)g,与术前比较差异有统计学意义(P<0.01)。术后 UEBW 平均下降43.68%,国际前列腺症状评分(IPSS)下降16.81分,Qmax 平均增加8.38 ml/s。结论膀胱重量作为一项无创性检查方法,对前列腺增生症进展的监测、术前评估和术后疗效的评价具有临床应用价值。
Objective To investigate the changes of bladder weight before and after transurethral resection of prostate (TURP) in benign prostatic hyperplasia (BPH) and its clinical significance. Methods 63 cases of BPH patients, including postoperative follow-up data of 21 cases complete with the same age without lower urinary tract symptoms in 30 males as a control group. Abdominal B ultrasound measurement of bladder wall thickness combined with bladder capacity in accordance with the spherical volume formula to estimate bladder weight. Urodynamic assessment of bladder outlet obstruction (BOO) and bladder function. Preoperative bladder weight (97 ± 54) g in 63 patients with BPH was (41 ± 14) g, positive correlation was found between bladder weight and LinPURR (R = 0.47), and maximal flow rate (Qmax) (R = -0.52), and was positively correlated with residual urine volume (R = 0.48), the difference was statistically significant (P <0.01), negative correlation with detrusor contraction strength (WF) , P <0.05). Twenty-one patients underwent preoperative B-ultrasound to estimate bladder weight (UEBW) (99 ± 50) g. Results The postoperative UEBW of 21 patients was (56 ± 21) g, which was significantly different from that before operation (P <0.01). Postoperative UEBW decreased by an average of 43.68%, International Prostate Symptom Score (IPSS) decreased by 16.81 points, Qmax increased by an average of 8.38 ml / s. Conclusion Bladder weight, as a noninvasive method, has clinical value in monitoring the progression of benign prostatic hyperplasia, preoperative evaluation and postoperative evaluation.