女性排尿困难患者的尿动力学分析  

Urodynamic analysis of dysuria in female patients

作　　者：果宏峰[1] 段继宏[1] 肖云翔[1] 吴士良[1] 那彦群[1] 

机构地区：[1]北京大学第一医院泌尿外科北京大学泌尿外科研究所,100034

出　　处：《中华外科杂志》2008年第20期1539-1541,共3页Chinese Journal of Surgery

摘　　要：目的比较女性排尿困难患者的尿动力学诊断分型在不同年龄组的差别。方法1997年3月至2008年7月，门诊以排尿困难为主诉的女性患者616例，无神经系统病史和下尿路手术史，行膀胱压力-流率测定及自由尿流率检查，按3个年龄组统计诊断分型。结果在〉18且≤40岁、〉40且≤60岁及60岁以上3个年龄组中，膀胱出口梗阻的比例均较高，分别为54．8％、59．1％和45．0％。逼尿肌过度活动、逼尿肌肌力弱、正常三项尿动力学检查结果在3组间无显著性差异，而膀胱出口梗阻、逼尿肌无反射两项分布有显著性差异。将〉18且≤40岁组与〉40且≤60岁组合并形成的中青年组与60岁以上的老年组比较，膀胱出口梗阻、逼尿肌无反射、逼尿肌肌力弱三项有显著性差异，膀胱出口梗阻在两组的比例为57．3％和45．0％，逼尿肌无反射在两组的比例为15．6％和23．9％，逼尿肌肌力弱在两组的比例为17．4％和25．0％。在逼尿肌肌力弱患者中，存在膀胱感觉减退的比例在老年组中明显升高。结论女性排尿困难患者的尿动力学诊断中，膀胱出口梗阻的比例最高，其比例在老年患者中有所下降，而逼尿肌无反射和逼尿肌肌力弱的比例在老年患者中增高。Objective To compare the urodynamic diagnostic types of dysuria in female patients of different age groups. Methods Six hundred and sixteen female patients with dysuria were evaluated from March 1997 to July 2008. No patients had history of nervous system disease and history of lower urinary tract operations. They had detrusor pressure-flow studies and uroflowmetry. The urodynamic diagnostic types were analyzed in 3 different age groups. Results In 3 groups of 18-40 years, 40-60 years and ≥60 years, the diagnosis of bladder outlet obstruction （BOO） had the highest proportion （54. 8%, 59. 1% and 45.0% respectively）. The distribution of detrusor overactivity, detrusor underaetivity and normal function had no significant difference between 3 groups. The distribution of BOO and acontractile detrusor had significantly difference between 3 groups. When groups of 18-40 years and 40-60 years were combined into 18-60 years group and compared with the older group, the proportion of BOO, acontractile detrusor and detrusor underactivity showed significantly difference. The proportions of BOO in the two groups were 57.3% and 45. 0%, acontractile detrusor 15. 6% and 23.9%, detrusor underactivity 17.4% and 25.0%, respectively. The proportion of reduced bladder sensation among detrusor underactivity patients in the older group was significantly higher. Conclusions In the urodynamic diagnoses of voiding difficulty in female patients, bladder outlet obstruction has the highest proportion. This proportion decreases in the older patients. The proportion of acontractile detrusor and detrusor underactivity increases in the older group.

关 键 词：女性 排尿困难 尿动力学 

分 类 号：R686[医药卫生—骨科学]