逼尿肌功率曲线分析在尿动力学研究中的应用  

Application of detrusor power curve analysis in urodynaimc studies

作　　者：刘宁[1] 满立波[1] 何峰[1] 黄广林[1] 周宁[1] 朱晓菲[1] 

机构地区：[1]北京积水潭医院泌尿外科,100035

出　　处：《中华泌尿外科杂志》2015年第3期221-224,共4页Chinese Journal of Urology

摘　　要：目的 探讨运用逼尿肌功率曲线计算排尿做功参数的方法及临床价值. 方法 回顾性分析2002年1月至2011年1月收治的132例男性下尿路症状患者的尿动力学检查结果,患者均无神经系统病史及阳性体征.年龄45 - 84岁,平均57岁.应用逼尿肌功率曲线方法计算患者的排尿做功、排尿功率和排尿能耗,并进行线性被动尿道阻力分析,根据逼尿肌压力分为降低、正常、升高3组,根据尿道阻力分为正常、升高2组,比较各组间最大尿流率时逼尿肌压（PdetQax）、最大尿流率（Qmax）、投射等容逼尿肌压（projected isovolumetric pressure,PIP）、排尿做功、排尿功率、排尿能耗等参数的差异. 结果 本组132例,根据逼尿肌收缩压分为降低组56例、正常组58例、升高组18例,3组的排尿做功分别为（1.1±0.5）、（1.7±0.7）、（2.1±1.2）J,排尿功率分别为（15.3±7.3）、（31.9±12.6）、（42.5±21.1） mW,排尿能耗分别为（3.9±1.2）、（5.2±1.9）、（6.2±3.2）J/L.3组的PdetQmax、Qmax、PIP、排尿做功、排尿功率、排尿能耗均随逼尿肌收缩压升高而增高,且差异均有统计学意义（P＜0.05）.根据尿道阻力分为正常组51例、升高组81例,排尿做功分别为（1.5±0.7）、（1.5±0.8）J,排尿功率分别为（32.3±13.2）、（22.6± 16.3） mW,排尿能耗分别为（3.8±0.7）、（5.4±2.4）J/L.升高组的PdetQmax、排尿能耗均高于正常组（P＜0.05）,而Qmax、排尿功率均低于正常组（P＜0.05）,两组间PIP、排尿做功的差异均无统计学意义（P＞0.05）. 结论 逼尿肌功率曲线分析可用于计算排尿期的做功参数,有助于评估膀胱的代偿功能,并有利于逼尿肌低压状态下的尿动力学分析.逼尿肌收缩压和尿道阻力均显著影响膀胱做功能力.Objective To establish a calculation method for the voiding work parameters by using the detrusor power curve and to evaluate its clinic efficacy.Methods From January 2001 to January 2011,132 male patients with benign prostate hyperplasia who underwent urodynamic tests were retrospectively reviewed.The patients＆#39; age ranged from 45 to 84 years old （mean 57 years old）.All patients had no previous history of neurological disease and no positive findings in neurological examinations.The voiding work of bladder,the voiding power of bladder and voiding energy consumption were calculated by using the detrusor power curve method and the linearized passive urethral resistance relation analysis was conducted.According to the detrusor status,all patients were divided into the decreased detrusor pressure group,the normal detrusor pressure group and the increased detrusor pressure group.Meanwhile,normal urethral resistance group and the increased urethral resistance group were classified according to the urethral resistance status.The detrusor pressure at maximal flow rate （PdetQmax）,the maximal flow rate （Qmax）,the projected isovolumetric pressure （PIP）,the voiding work,the voiding power and the voiding energy consumption were compared among the different groups.Results There were 56 cases,58 cases,18 cases in the decreased,normal and the increased detrusor pressure group respectively.The voiding work were （1.1 ± 0.5）J,（1.7± 0.7）J,（2.1±1.2）J; the voiding power were （15.3±7.3）mW,（31.9±12.6）mW,（42.5±21.1）mW; and the voiding energy consumption were （3.9± 1.2） J/L,（5.2± 1.9） J/L,（6.2±3.2） J/L in those three groups,respectively.With the increasing of detrusor pressure,PdetQ Q PIP,the voiding work,the voiding power and the voiding energy consumption all increased among three groups with significant difference （P〈 0.05）.There were 51 cases,81 cases in the normal and the increased urethral resistance group.The voiding work were （1.5±0.7）J and （1.5±0.8�

关 键 词：尿动力学 膀胱功能 逼尿肌 做功 功率 

分 类 号：R691[医药卫生—泌尿科学]