老年男性留置导尿患者尿动力学检查分析  

Analysis of urodynamics in elderly male patients with indwelling urinary catheterization

作　　者：赵文锋[1] 果宏峰[1] 金石华[1] 汪磊[1] 李宁忱[1] Zhao Wenfeng;Guo Hongfeng;Jin Shihua;Wang Lei;Li Ningchen(Department of Urology,Peking University Shougang Hospital,Peking University Wu-Jieping Urology Center,Beijing 100144,China)

机构地区：[1]北京大学首钢医院吴阶平泌尿外科中心,100144

出　　处：《中华老年医学杂志》2019年第12期1368-1371,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨老年男性留置导尿患者尿动力检查的临床特点。方法回顾性分析我中心497例60岁及以上老年男性留置导尿患者尿动力学检查相关资料。将497例患者根据年龄分为60~69岁组114例、70~79岁组220例,80~111岁组163例;根据留置导尿时间分为1~2周组262例、2~4周组47例、4周以上组188例。观察各组患者留置导尿的原因和膀胱出口梗阻、逼尿肌肌力等。结果老年男性留置导尿的原因以急性尿潴留较多见(55.1%,274例),最常见的诊断为前列腺增生(90.3%,449例);χ2值分别为1.606、0.199、2.477,均P>0.05)。留置尿管时间1~2周、2~4周、4周及以上组患者膀胱出口梗阻分别为56.9%(149/262)、55.3%(26/47)、42.6%(80/188),差异有统计学意义(χ2=9.315,P<0.05);逼尿肌无收缩分别为15.6%(41/262)、12.8%(6/47)、29.8%(56/188),差异有统计学意义(χ2=15.319,P<0.01)。不同年龄组尿动力学检查结果比较,差异均无统计学意义(均P>0.05)。结论膀胱出口梗阻是引起老年男性留置导尿的主要原因,留置导尿1~2周后可行尿动力学检查;年龄对老年男性患者留置导尿时间长短无明显影响;留置导尿时间对逼尿肌肌力正常和逼尿肌肌力弱患者的尿动力学诊断影响不大;留置导尿时间4周以上,逼尿肌无收缩的可能较大。Objective To investigate clinical characteristics of urodynamics in elderly male patients with indwelling urinary catheterization.Methods Clinical urodynamics of 497 male patients with indwelling urinary catheterization aged 60 years and over from December 2010 to April 2019 in our center were retrospectively analyzed and divided into 3 groups:60-69-year-old group(n=114),70-79-year-old group(n=220),and 80-111-year-old group(n=163).According to the catheter indwelling time,the patients were divided into 3 groups:1-2 weeks group(n=262),2-4 weeks group(n=47)and over 4 weeks group(n=188).The cause of indwelling urinary catheterization,bladder outlet obstruction,acontractile detrusor and other indicators were observed.Results The main cause of indwelling urinary catheterization in elderly men was acute urinary retention(55.1%,274 cases),in that the most common diagnosis was benign prostatic hyperplasia(90.3%,449 cases).No statistically significant difference in the different catheter indwelling time-related urodynamics between the different age groups was found(χ2=1.606,0.199 and 2.477,all P>0.05).There were statistically significant differences both in the incidences of bladder outlet obstruction between the 1-2 weeks vs.2-4 weeks vs.over 4 weeks groups[56.9%(149/262)vs.55.3%(26/47)vs.42.6%(80/188),χ2=9.315,P<0.05)],and in the incidences of acontractile detrusor between the 1-2 weeks vs.2-4 weeks vs.over 4 weeks groups[15.6%(41/262)vs.12.8%(6/47)vs.29.8%(56/188),χ2=15.319,all P<0.05)].There was no statistically significant difference in catheter indwelling time-related urodynamics between two groups with normal detrusor muscle function and weak detrusor muscle function(P>0.05).Clinical urodynamics had no statistically significant in different age groups(P>0.05).Conclusions Bladder outlet obstruction is the main cause of indwelling urinary catheterization in elderly men.Urodynamic examination can be performed 1-2 weeks after indwelling urinary catheterization.Age has no significant effect on the catheter indwelling

关 键 词：导尿管插入术 尿动力学 

分 类 号：R47[医药卫生—护理学]