慢性前列腺炎患者的尿动力学检查

作者：马汉彬，陈复纯，肖广潮

【关键词】 慢性前列腺炎

摘 要：目的：探讨慢性前列腺炎可能存在的下尿路症状，结合尿动力学检查分析其原因。方法：采用丹迪尿流测定仪对20例慢性前列腺炎患者进行尿流率、充盈性膀胱侧压、压力―流率测定、尿道侧压及肌电图检查。结果：不稳定性膀胱9例（45%），低顺应性膀胱5例（25%），膀胱出口梗阻11例（55%），逼尿肌尿道括约肌协同失调7例（35%），其中不稳定膀胱合并膀胱出口梗阻6例，低顺应性膀胱合并膀胱出口梗阻4例，不稳定膀胱合并逼尿肌尿道外括约肌协同失调2例。结论：慢性前列腺炎患者的下尿路症状与不稳定性膀胱、低顺应性膀胱、膀胱出口梗阻及逼尿肌尿道外括约肌协同失调有关，了解这些相关因素对治疗有重要的指导意义。

　　关键词： 尿动力学； 慢性前列腺炎

　　The Urodynamic Study on Patients with Chronic Prostatitis

　　Abstract: Objective：The aim of the study was to explore the possible symptom of inferior urinary tract in patients with chronic prostatitis urodynamic. Methods：20 patients with chronic prostatitis urodynamic were measured the urine flow rate , engorged bladder lateral pressure, pressure - flow rate , lateral pressure of urinary tract by using the DANDI urodynamic radiomete and underwent electromyogram examination . Result: Unstable bladder in 9 cases(45%), low compliance bladder in 5 cases (25%) , obstruction in the bladder outlet in 11 cases (55%), dyssynergia in detrusor muscle and external urethral sphincter in 7 cases (35%), unstable bladder with obstruction in the bladder outlet in 6 cases, low compliance bladder with obstruction in the bladder outlet in 4 cases , unstable bladder with dyssynergia in detrusor muscle and external urethral sphincter in 2 cases .Conclusion : The symptom of inferior urinary tract in patients with chronic prostatitis urodynamic was related to the unstable bladder, low compliance bladder , obstruction in the bladder outlet and dyssynergia in detrusor muscle and external urethral sphincter ,to know the correlation factors do significant benefit in guiding the clinical treatment.

　　Key words: Urodynamic; Chronic prostatitis

　　慢性前列腺炎（Chronic prostatitis CP）是一种常见病，约占泌尿外科门诊病人的25%，目前对其发病机制不很明确，治疗效果不满意，而尿动力学可对其下尿路症状作出客观反映，为患慢性前列腺炎患者治疗提供理论依据。

　　1 资料与方法

　　1.1 病例选择：选取2003年1月至2004年6月的CP患者20例，年龄20～40岁，平均28.5岁。患者均有不同程度的下腹会阴部酸胀、尿频、尿急、尿道灼热及排尿不畅症状，所有病例均排除有肾、输尿管疾病、前列腺增生及前列腺癌、睾丸及附睾炎等疾病。20例患者的诊断均符合国际健康学会（NIH）慢性前列腺炎诊断标准［1］。

　　1.2 检测方法：采用丹迪公司的尿动力学分析仪和自制半卧位床，对20例CP患者进行尿流率、充盈性膀胱测压、压力―流率测定、肌电图同步检测、尿道测压。膀胱测压时用生理盐水按50ml/min持续膀胱灌注，尿道测压时生理盐水灌注速度为2ml/min，导管退出速度为2mm/S。检测前患者常规停药一周。

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