尿动力学联合膀胱尿道造影在女性压力性尿失禁诊断中的价值  

Significance of urodynamic examination combined with voiding cystourethrography in the diagnosis of female stress urinary incontinence

作　　者：沈华[1,2] 于洪波[1,2] 吴宏飞[1,2] 周鹤同[1,2] 张斌[1,2] 林建中[1,2] 

机构地区：[1]南京明基医院泌尿外科 [2]南京医科大学附属医院,江苏南京210019

出　　处：《现代泌尿外科杂志》2011年第6期511-513,共3页Journal of Modern Urology

摘　　要：目的探讨尿动力学检查联合排泄性膀胱尿道造影在女性压力性尿失禁诊断中的应用价值。方法回顾性分析56例临床诊断为女性压力性尿失禁(SUI)的患者,年龄(59.2±8.2)岁,每例均行尿动力学和排泄性膀胱尿道造影检查,评估膀胱顺应性、逼尿肌稳定性、尿道压、膀胱及尿道的形态。结果尿动力学检查提示最大尿流率(33.6±7.7)mL/s,残余尿(17.8±14.7)mL,膀胱顺应性正常,膀胱容量(356.3±99.3)mL,33例测得腹压漏尿点压(49.8±17.6)cmH2O,最大尿道闭合压(47.4±10.5)cmH2O,功能性尿道长度(2.6±0.6)cm。相关性分析显示病程与腹压漏尿点压高度负相关(r=-0.816,P<0.01)。排泄性膀胱尿道造影见膀胱颈及近端尿道下移34例,膀胱尿道后角变钝或消失44例,静息期膀胱颈和近端尿道呈漏斗形7例,咳嗽时47例见造影剂从尿道溢出。结论在无影像尿动力学设备的单位,尿动力学检查和排泄性膀胱尿道造影联合应用对SUI的诊断和术前评估具有重要的价值,比单用一种方法更具有临床意义。Objective To investigate the significance of urodynamic examination combined with voiding cystou（ethrography （VCUG） in the diagnosis of female stress urinary incontinence （SUI）. Methods Data of 56 patients （aged 47-79 years） with female SUI were retrospectively reviewed. Urodynamic examination and VCUG were performed to evaluate bladder compliance, detrusor muscle stability, urethral pressure, shapes of bladder and urethra. Results Urodynamic examinations showed that average maximum uroflow was （33.6±7.7）mL/s, post-void residual was （17.8± 14.7）mL, bladder capacity was （356.3±99.3） mL, average abdominal leak point pressure （ALPP） of 33 cases was （49.8 ± 17.6） cmH2O, maximum uretharal closure pressure was （47.4±10.5）cm H2O, functional urethral length was （2.6 ±0.6）cm and the bladder had normal compliance. Bivariate correlation analysis displayed an significant inverse relationship between course of disease and ALPP （r =-0. 816, P〈0. 01）. VCUG showed that the bladder neck and urethra in 34 cases descended caudally. 44 patients had blunting or disappeared vesicourethral angle, and 7 patients opened vesical neck and proximal urethra at rest in the absence of detrusor contraction. Contrast medium was observed out of the urethra in 47 patients when they coughed. Conclusions In hospitals without videourodynamics equipment, combined application of urodynamic examination and VCUG is significant in the diagnosis and preoperative evaluation of SUI.

关 键 词：压力性尿失禁 尿动力学 排泄性膀胱尿道造影 影像尿动力学 

分 类 号：R695.1[医药卫生—泌尿科学]