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[良性前列腺增生的排尿障碍评估与保守药物治疗]

[Assessment of voiding disorders and conservative pharmacological treatment of benign prostatic hypertrophy].

作者信息

Park Y C, Takada M, Sugiyama T, Matsuura T, Kaneko S, Akiyama T, Kurita T, Yachiku S

出版信息

Hinyokika Kiyo. 1986 Nov;32(11):1576-83.

PMID:2435121
Abstract

The symptoms of benign prostatic hypertrophy consist of two major groups, obstructive symptoms and irritative symptoms. Uroflowmetry is a safe, easy and accurate method to assess the obstructive symptoms. Furthermore, electromyography of abdominal wall and the monitoring of rectal pressure is helpful to know involvement of abdominal straining. Cystometry provides us objective findings of bladder irritability in bladder outlet obstruction. Detrusor hyperreflexia was revealed in 55%, and uninhibited detrusor contraction was revealed in 22.5% of the patients with benign prostatic hypertrophy. The most sophisticated technique to estimate the volume of prostatic adenoma is transrectal ultrasonotomography. The value, cranio-caudal X left-right X antero-posterior axis length, has been proved to closey correlate to the resected volume of the prostatic adenoma. However there was no correlation between the estimated prostatic volume and the severity of dysuria. The comparison of the uroflow rates before and after loading phentolamine is a helpful method to determine the sympathetic influence to lower urinary tract obstructions. This test differentiates functional obstruction from organic obstruction. Conservative pharmacological therapy on the patients with benign prostatic hypertrophy were also studied. The value of efficacy of prazocine hydrochloride (0.5-6.0 mg/day), Eviprostat (6Tab/day), Prostetin (200-400 mg/day), Hachimi-Jiogan (5 g and 7.5 g/day) on subjective symptoms were 47.8 86.2, 58.5, 52.9 and 66.7% respectively. Ninety-one of the 141 patients with benign prostatic hypertrophy who visited the out-patient clinic in 1983 were given pharmacological treatment initially.

摘要

良性前列腺增生的症状主要分为两大类,即梗阻性症状和刺激性症状。尿流率测定是一种评估梗阻性症状的安全、简便且准确的方法。此外,腹壁肌电图和直肠压力监测有助于了解腹压增加的情况。膀胱测压可提供膀胱出口梗阻时膀胱激惹的客观表现。55%的良性前列腺增生患者显示逼尿肌反射亢进,22.5%的患者显示逼尿肌无抑制性收缩。估计前列腺腺瘤体积的最精密技术是经直肠超声断层扫描。已证明其值,即头 - 尾径×左右径×前后径的长度,与前列腺腺瘤的切除体积密切相关。然而,估计的前列腺体积与排尿困难的严重程度之间并无关联。比较酚妥拉明负荷前后的尿流率是确定交感神经对下尿路梗阻影响的一种有用方法。该试验可区分功能性梗阻和器质性梗阻。还对良性前列腺增生患者的保守药物治疗进行了研究。盐酸哌唑嗪(0.5 - 6.0毫克/天)、前列康(6片/天)、保前列(200 - 400毫克/天)、八味地黄丸(5克和7.5克/天)对主观症状的有效率分别为47.8%、86.2%、58.5%、52.9%和66.7%。1983年到门诊就诊的141例良性前列腺增生患者中,有91例最初接受了药物治疗。

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