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目的 探讨热磁疗法联合药物综合治疗80岁以上高龄前列腺电切术后再次尿潴留的临床疗效。方法 对36例80岁以上高龄良性前列腺增生（BPH）并急性尿潴留（AUR）患者进行前列腺电切术，术前、术后行尿流动力学检查，将术后5 d拔出尿管后再次尿潴留者随机分Ⅰ、Ⅱ组，各18例，Ⅰ组热磁疗法联合冰盐水间断冲洗膀胱，服用溴吡斯的明、甲钴胺、维生素B1综合治疗；Ⅱ组单纯热磁疗法，1周后均拔出尿管，评估疗效。结果 36例术前均为逼尿肌收缩无力，术后12 d有30例均能自主排尿（Ⅰ组17例，Ⅱ组13例），Ⅰ组较Ⅱ组残余尿量明显减少［（50±10）mL vs（120±40）mL］，最大尿流率增加［（16±10）ml/s vs（10±6）ml/s］，最大逼尿肌压显著改善［（80±60）cmH2O vs （50±45）cmH2O］，组间比较，差异有统计学意义（分别为P＜0.05、0.01、0.01），排尿时间、每次排尿量、夜尿次数比较，差异均无统计学意义（P＞0.05），6例（Ⅰ组1例，Ⅱ组5例）仍排尿不出者行造瘘术或留置尿管。结论 逼尿肌收缩无力是高龄BPH并AUR患者术后再次尿潴留的主要原因，热磁疗法联合药物、冰盐水刺激膀胱收缩对改善排尿有显著效果。
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临床研究
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更新时间：2015-07-24
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热磁疗法联合药物综合治疗80岁以上前列腺电切术后再次尿潴留的疗效观察
Efficacy of thermal magnetic therapy combined with medicine in treating the patients over 80 years old with recurrent urinay retention after TURP
微创医学 201502期 页码：176-179
作者机构：（1 广东省中西医结合医院暨南海区中医院泌尿外科，佛山市528200；2 广东省广州市第一人民医院泌尿外科，广州市510180）
基金信息：作者简介：廖土明（1974～），男，硕士，副主任医师，研究方向：前列腺疾病。（收稿日期：2015-01-16 修回日期：2015-03-10）
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Objective To evaluate the clinical effect of thermal magnetic therapy combined with medicine in treating the patients over 80 years old with recurrent urinay retention after TURP. Methods TURP was carried out in 36 patients over 80 years old with AUR secondary to BPH. All patients underwent urodynamic study preoperation and postoperation. Those having urinay retention again at fifth postoperative day wre divided into 2 groups (each 18 cases) randomly. The first group underwent thermal magnetic therapy combined with “ice” saline by intermittent washing down bladder, taking pyridostigmine bromide, mecobalamine,Vitamin B1 orally. The second group underwent thermal magnetic therapy only. The urethral tube was removed after 1 week. ResultsAll 36 cases showed poor contractility of detrusor muscle in preoperation. 30 patients were able to void on day 12 postoperation (the first group had 17 cases and the second group had 13 cases).Compared with the second group, the first group had less residual urine volume(50±10ml vs 120±40ml),more maximum flow rate (16±10ml/s vs 10±6ml/s),better maximum detrusor pressure (80±60 cmH2O vs 50±45 cmH2O) (P＜0.05,0.01, 0.01, respectively). And there were no significant differences in micturition time, micturition volume of each time, nocturia frequency(P＞0.05). 6 cases still need cystostomy or catheterization. Conclusion Poor contractility of detrusor muscle was a main factor to cause urinay retention again after TURP among older men with AUR secondary to BPH. Thermal magnetic therapy combined with medicine and “ice” saline stimulating bladder can improve the function of urination.
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