B超影像尿动力学检查在诊断小儿下尿路功能障碍中的应用  

Evaluation of video urodynamic study with B-mode ultrasound in children with lower urinary tract dysfunction

作　　者：文建国[1] 刘奎[1] 李真珍[1] 张红[1] 杜爱民[1] 王庆伟[1] 张瑞丽[1] 

机构地区：[1]郑州大学第一附属医院小儿外科和小儿尿动力学中心

出　　处：《中华小儿外科杂志》2007年第8期412-415,共4页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金(30571931);河南省高校杰出科研人才创新工程(2001KYCX004);河南省高等学校创新人才培养工程(2002-2007)支持项目

摘　　要：目的探讨B超影像尿动力学检查在下尿路功能障碍患儿诊断中的应用价值。方法69例小儿分2组,患儿组54例,为下尿路功能障碍的患儿,男30例,女24例,年龄4～18岁,平均(10.7±3.6)岁;对照组15例,为下尿路正常的患儿(因上尿路异常作下尿路检查者),男11例,女4例,年龄3～17岁,平均(9.9±3.7)岁。分别进行尿动力学检查,同步耻骨上、会阴部和直肠B超观察膀胱壁厚度、膀胱颈口形态、膀胱充盈和排尿后尿道形态等。结果患儿组尿动力学异常表现有残余尿量增多、膀胱顺应性降低、逼尿肌过度活动、逼尿肌括约肌协同失调和逼尿肌瘫痪等,B超影像检查异常表现有膀胱壁增厚、毛糙,颈口抬高,后尿道扩张,排尿期尿道开放不完全等,其中2例后尿道瓣膜患儿发现膀胱憩室。对照组B超影像检查显示充盈期膀胱壁光滑,厚度(2±1)mm,均小于3 mm;膀胱颈口关闭,无抬高;排尿期膀胱颈口、后尿道充分开放,残余尿量小于10ml。结论B超影像尿动力学检查可将膀胱的功能性改变和形态学信息相结合,能更全面准确地诊断和了解下尿路功能障碍。Objective To investigate the significance of B-ultrasound urodynamie study in children with lower urinary tract dysfunction （LUTE））. Methods Sixty-nine cases were divided into two groups. Patients group （54 cases） with LUTE） included 30 boys, 24 girls, aged from 4 to 18 years old （10. 7＋±3. 6）y. Control group （15 cases） included 11 boys, 4 girls, aged from 3 to 17 years old （9. 9±3.7）. B-ultrasound urodynamie study was performed in all cases with simultaneously observing bladder wall thickness, bladder neck and posterior urethral shape during both filling and voiding phrase, through suprapubic, perineum or transreetum. Results Patient group is manly showed increasing post-voiding urine volume, detrusor overaetivity, detrusor-sphineter dyssynergia, ineontrae- tile detrusor. B-ultrasound urodynamie study in control group showed smooth bladder wall and its thickness was （2 ± 1 ） ram, bladder neck and posterior urethra opened completely during voiding phrase. Post-voiding urine volume was less than 10 ml. The essential manifestations of B-ultrasound urodynamic study of patients were bladder wall thickened and unsmooth, bladder neck raised, dilated posterior urethra and partially opening urethra during voiding phase. Bladder diverticulum was observed in two children with posterior urethral valve preoperatively. Conclusions B-ultrasound urodynamic study do improved accuracy and efficacy of diagnosis of lower urinary tract dysfunction in children.

关 键 词：超声检查 尿动力学 膀胱 尿道 

分 类 号：R726.9[医药卫生—儿科]