天津医药

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BPH突入膀胱内的长度与相关并发症的比较分析

王晓佳1,韩瑞发2,雷铭德2,李世宾2   

  1. 1. 天津医科大学第二附属医院，天津市泌尿外科研究所，天津市泌尿外科基础医学重点实验室
    2. 天津市泌尿外科研究所
  • 收稿日期:2010-03-31 修回日期:2010-05-21 出版日期:2010-08-15 发布日期:2010-08-15
  • 通讯作者: 王晓佳

Assessed correlation of the length of intravesical prostatic protrusion with the clinical complication in patients with benign prostatic hyperplasia

  • Received:2010-03-31 Revised:2010-05-21 Published:2010-08-15 Online:2010-08-15

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摘要： 摘要：目的: 比较分析良性前列腺增生突入膀胱（intravesical prostatic protrusion,IPP）的长度与临床相关症状的关系。 方法：回顾性分析2007年11月-2009年11月我院收治的良性前列腺增生症（benign prostatic hyperplasia,BPH）患者218例，经腹部超声检查，电子尺确定IPP长度，按Tan YH的方法，将前列腺增生突入膀胱内的长度分为三级（I级 IPP≤5mm，II级 IPP＞5mm ≤10mm，III级 IPP＞10mm）。比较分析IPP长度与临床相关症状的关系。 结果：IPP长度与前列腺体积、血清PSA、残余尿量，膀胱出口梗阻指数呈明显的正性相关（Spearman's rho=0.497，0.346，0.334，0.659，p <0.01），IPP分级与最大尿流率呈负性相关（Spearman's rho =-0.139, p < 0.05)。前列腺体积在各IPP分级间差别有显著统计学意义，（P<0.01）。 PSA、最大尿流率、排尿后残尿、膀胱出口梗阻指数在IPP I级/II级与III级间差异具有统计学意义，（P < 0.05）。并发症的发生率与IPP分级增加呈递增性升高，分别为40.82%，58.62%，68.47%，（P=0.004）。49名患者存在两种以上的严重并发症，IPP III级患者 65.31% (32/49例)，IPP II和IPP I级分别为 20.41% (10/49例)和 14.28%（7/49例）。IPP分级间接受手术治疗的比率为67.35%、89.66%、97.30%，（ P＜0.01)。结论：IPP长度与前列腺体积参数、PSA值和排尿参数具有明显的相关性，IPP高分级与低分级患者并发症的发生率和严重程度密切关联， IPP分级可作为药物治疗和手术治疗的一个重要的参照指标。

关键词: 良性前列腺增生, 膀胱内前列腺突入程度, 分级, 并发症

Abstract: Abstract：Objective: We assessed correlation of intravesical prostatic protrusion（IPP） with the clinical symptoms in patients with benign prostatic hyperplasia(BPH).Methods: We retrospectively assessed 218 BPH patients from November 2007 to November 2009 in our hospital，IPP was measured by transabdominal ultrasound, accordance with Tan YH’s methods,the length of protrusion was classified as three group: IPP I 1-5mm or less,IPP II greater than 5 to 10mm and IPP III greater than 10mm.We assessed correlation of the length of IPP with clinical symptoms in patients with BPH.Results: IPP was found positively correlated with the prostate volume(PV), prostate-specific antigen(PSA), postvoid residual urin volume(PVR)and bladder out obstruction index(BOOI)(Spearman's rho=0.497，0.346，0.334，0.659，p <0.01）, negatively correlated with the peak urinary flow rate(Qmax)（Spearman's rho =-0.139, p < 0.05). PV was found statistically different between the per group（P<0.01）, PSA、Qmax、PVR and BOOI were found statistically different between IPP I and III（P < 0.05）,and between IPP II and III（P < 0.05）. Incidence of complication are increase with the step up of the group, were 40.82%，58.62%，68.47%,respectively. And the incidence was found statistically different between the per group（P=0.004）.There are 49 patients with serious complication,32 patients in IPP III(65.31%),10 in IPP II(20.41%)and 7 in IPP I(14.28%). The incidence of patients, who selected surgery ,are found statistically different between the per group,were 67.35%、89.66%、97.30%,respectively（ P＜0.01).Conclusion:There is a close correlation between the length of IPP with the voluminal and micturitional parameters of BPH,and between the degree of IPP with the incidence and severity of complication.Length of IPP could applied to reference of therapeutics.

Key words: benign prostatic hyperplasia, intravesical prostatic protrusion, grade, complication