| 前列腺增生致上尿路损害的临床机制研究 |
| 投稿时间：2010-03-15 修订日期：2010-05-27 点此下载全文 |
| 引用本文：李新,李雪梅,宋波,金锡御,方强,周占松,李为兵.前列腺增生致上尿路损害的临床机制研究[J].医学研究杂志,2010,39(8):40-42 |
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| 基金项目:国家自然科学基金（30973005）；重庆市科技攻关计划项目（CSTC3009AC5026） |
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| 中文摘要:目的探讨前列腺增生致上尿路损害的致病机制，为临床治疗和预防提供理论依据。方法对264例排尿功能障碍性导致上尿路功能损害病例的尿动力学、泌尿影像学及肾脏功能学资料进行全面分析。结果在引起上尿路损害的264例前列腺增生病人中，部分患者（42.4%，n=112）残余尿量不多（<100cmH2O），但已引起上尿路损害；78.4%(n=207)以上患者膀胱储尿期压力大于40cmH2O，初始尿意压力（42.3±6.0cmH2O）和最大尿意压力（67.3±5.8cmH2O）均在膀胱安全压力（40cmH2O）之上；初始尿意容量（417.5±61.6ml）明显大于安全容量（364.6±42.1ml）。结论前列腺增生所导致的膀胱储尿期压力增高、达到和(或)超过安全压仍继续储尿是导致上尿路损害的最重要原因；残余尿和尿意不能作为指导排尿的指标；将膀胱压降至安全压以下或在安全容量前排空膀胱是治疗前列腺增生和预防上尿路损害的基本原则。 |
| 中文关键词:前列腺增生 上尿路 尿动力学 |
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| Clinical Study on the Upper Urinary Tract Damage Due to BPH |
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| Abstract:ObjectiveTo clarify the urodynamic mechanism of BPH due to voiding dysfunction. Methods264 patients with BPH were evaluated with urodynamic studies from Jan 1999 to April 2009.ResultsBladder outlet obstructure(100%，n=264) was the main pathologic change in BPH patients. Upper urinary tract damage had been occurred in patients（42.4%，n=112） with lower residual urine（<100ml）.78.4%(n=207) of the patients had the higher vesical pressure than 40cmH2O. The average volume（417.5±61.6ml） at the fist desire to voiding was higher than that of safe volume（364.6±42.1ml）.ConclusionBPH could increase the bladder pressure during urine starage. Keeping the vesical pressure under safe value and voiding befor safe volume could prevent upper urinary from damaging. |
| keywords:BPH Upper urinary tract Urodynamics |
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