脊髓损伤并发上尿路扩张的危险因素分析  

Analysis of the risk factors of upper urinary tract dilatation due to spinal cord injury

作　　者：高伟兴[1] 李晓强[1] 曹凤宏[1] 王宝贵[1] 张立国[1] 丁雪飞[1] 

机构地区：[1]华北煤炭医学院附属医院泌尿外科,唐山063000

出　　处：《中华外科杂志》2007年第6期402-404,共3页Chinese Journal of Surgery

摘　　要：目的探讨脊髓损伤患者并发上尿路扩张的尿动力学危险因素。方法随机抽取唐山地震脊髓损伤患者96例,经 B 超检查并发上尿路扩张16例为 A 组,无上尿路扩张80例为对照组B组,分别进行尿动力学测定。而后对两组患者间性别、年龄和尿动力学等参数进行单因素和多因素分析。结果男性上尿路扩张发生率明显高于女性,A 组残余尿量、最大膀胱容量、逼尿肌漏点压和膀胱低顺应性发生率明显高于 B 组,而两组年龄、逼尿肌反射亢进发生率、相对安全容量、逼尿肌括约肌协同失调发生率、最大尿流率和最大尿道关闭压差异无统计学意义。Logistic 回归分析结果显示,膀胱低顺应性是筛选出的惟一危险因素。结论对脊髓损伤患者及时进行尿动力学检查,阻止或减缓膀胱顺应性的改变,可防止上尿路扩张的发生。Objective To evaluate the uredynamic risk factors of upper urinary tract dilatation （UUTD） secondary to spinal cord injury （SCI）. Methods Ninety-six SCI patients of Tangshan earthquake were divided into 2 groups by ultrasonography： 16 SCI patients （group A） with UUTD and 80 SCI patients （group B） without UUTD received urodynamic test. Responses were evaluated using single and multiple analysis after examination. Results The incidence of male was significantly higher than that of female. Residual urine volume, maximum cystometric capacity, detrusor leak point pressure and the incidence of bladder low compliance in group A were signilicandy higher than those in group B. There were no significant differences in age, the incidence of detrusor hyperreflexia, relative safe Madder capacity, the incidence of detrusor-sphincter dyssynergla, maximum flow rate and maximum urethral closure pressure between 2 groups. Bladder low compliance was cardinal risk factors according to Logistic regression analysis. Conclusion An early urodynamic examination and treatment for SCI patients are important to prevent from bladder low compliance and upper urinary tract damage.

关 键 词：脊髓损伤 泌尿系疾病 上尿路扩张 尿动力学 

分 类 号：R651.2[医药卫生—外科学]