【作者】 陆洪兵；

【导师】 严春寅；

【作者基本信息】 苏州大学 ， 外科学， 2002， 硕士

【摘要】 为了探讨尿动力学检查在前列腺网状支架治疗中的价值，探讨前列腺网状支架治疗前后支架及后尿道形态变化的规律，进一步提高支架治疗的准确性。选择35例前列腺增生引起的尿潴留的老年病人进行支架治疗，他们由于各种其他疾病而不能耐受开放手术和TURP术，治疗前后分别进行尿动力学检查。结果：所有病人有膀胱出口梗阻(BOO)的存在，24例逼尿肌功能正常或高于正常，11例逼尿肌无力。根据尿道压分布测得后尿道长为5.36±0.91cm，选择支架长为3.33±0.66cm。支架治疗后测得后尿道长为5.97±0.97cm，支架长变为4.14±0.74cm，比术前均有延长。支架治疗成功后测得支架远端离尿道外括约肌间的距离为2.00±0.80cm。根据B超测得的前列腺尿道长来选择支架的正确率为80.1％，结合尿道压测定选择支架的正确率为97.3％。结论：尿动力学检查可以明确支架治疗的适应征；可以提高支架长度选择的正确性；术后检查可以确定支架在后尿道中的位置，明确支架及后尿道形态变化的特点，我们也可以知道支架治疗失败的原因。更多还原

【Abstract】 To evaluate the value of the urodynamics in the bladder outlet obstruction (BOO) treated with wallstent, to probe the shifty orderliness of stent and posterior urethral before and after the stent implantation , in order to increase the accuracy of stent implantation . We chose 35 old patients with urinary retention caused by benign prostatic hyperplasia (BPH) or prostatic cancer (Pca) , they couldn’t bear the open operation or TURP because of the other diseases . Urodynamics performed before and after the wallstent implantation . Results: All the patients had BOO and were fit for implanting wallstent, the function of bladder detrusor was normal or hyper in 24 patients ; the function of bladder detrusor was acontractile in 11 patients .The length of posterior urethral measured by the urethral pressure was 5.36±0.9lem before implantation , the length of wallstent we choosed was 3.33 ±0.66cm . The length of posterior urethral was 5.97±0.97cm after implantation , the length of wallstent was changed to 4.14 ± 0.74 cm , they all prolonged after the treatment . the length of stent to outer urethral constrictor was 2.00 ± 0.80cm after satisfied implantation .The correct rate of choosing stent was 80.1% according to the length of prostate measured by transrectal ultrasound , the correct rate was 97.3% when we combined with urethral pressure . conclusion : Urodynamics could tell us the stent implanted indication , could improve the correctness of choosing stent;After implantation , urodynamics could determine the stent location in the posterior urethral, we could understand the shifty orderliness of stent and posterior urethral, and we also knew the reason why we were fail in stent treatment.更多还原