遗尿伴急迫性和排尿延缓性尿失禁患儿膀胱功能的尿动力学评估  

Urodynamic evaluation of the children with enuresis nocturna accompanied by daytime urge incontinenceor daytime voiding postponement

作　　者：文建军[1] 芦山[2] 齐林[2] 文建国 张艳 娄安峰 任川川 王焱 张瑞莉 

机构地区：[1]郑州大学第一附属医院急诊科和泌尿外科,450052 [2]郑州市儿童医院 [3]河南省高校临床开放重点实验室

出　　处：《中华小儿外科杂志》2011年第8期595-599,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨夜间遗尿伴白天急迫性尿失禁（UI）和夜间遗尿伴白天排尿延缓性尿失禁（VPI）患儿的尿流动力学表现，为临床治疗提供依据。方法本研究选取2008年6月至2009年10月间因夜间遗尿伴白天尿失禁诊断的患儿64例，进行详细的体格检查、腰椎X线、泌尿系超声并测定膀胱壁厚度、尿常规，尿动力学检查。将患儿分为UI和VPI两组。结果UI组与VPI组比较：膀胱壁厚度较正常增厚比例（5％比20％，P％0．05），两组中伴随尿痛、便秘等显著临床症状（13％比36％，P〈0．05）。最大尿流率VPI组与UI组分别为（20．2±9．0）ml／s、（14．1±11．6）ml／s（P〈0．05），最大尿道压VPI组与UI组分别为（152．3±47．5）cmH2O、（107．7±40．3）cmH2O（P〈0．05）。结论VPI患儿更易出现躯体不适及明显临床症状，VPI的尿动力改变和临床症状明显较UI严重，这些儿童有必要常规行尿动力学检查了解膀胱功能，为规范治疗提供依据。Objective To evaluate the urodynamic parameters of the children with enuresis nocturna accompanied by daytime urgency incontinence （UI） or daytime voiding postponement incontinence （VPI）. Methods From June 2007 to October 2009, a total of 64 children who had enuresis nocturna accompanied by daytime UI or daytime VPI were recruited in this study. The urodynamies parameters including uroflowrnetry, bladder pressure-volume, and static urethral pressure were examined and recorded. The physical examination, X-ray radiography, ultrasonography and urinalysis were also studied. Results In the patients with VPI, 20% patients had thicker bladder wall, and only 5% of UI patients had thicker bladder wall （P〈0. 05）. Pain with urinating and constipation occurred in 13% UI patients, and 36% VPI patients （P〈0. 05）. The maximum flow rate in VPI patients was higher than that in UI patients （20. 20 ±9. 02 vs. 14. 09± 11.56 ml/s,P〈0. 05）. Maximum urethral pressure in VPI patients was higher than that in UI patients （152. 3± 47. 5 vs 107. 7 ±40. 3 cmH2 O, P = 0. 003）. Conclusions The symptoms and urodynamic dysfunction of the children with enuresis nocturna accompanied by VPI are more severe than those of the UI patients. The therapeutic plan should be made according to the urodynamic evaluations of these patients.

关 键 词：尿动力学 尿失禁 儿童 膀胱 

分 类 号：R726.9[医药卫生—儿科]