膀胱安全测定装置在脊髓损伤患者膀胱功能诊断中的应用研究  

The application of bladder safety measurement device in the diagnosis of bladder functions in patients with spinal cord injury

作　　者：石秀秀[1] 杜宁 秦江[1] 孙海燕[1] 原艳丽 吴金玲 何晓庆[1] 王金云 胡鸢[1] 唐金树[1] 郁华亮[2] SHI Xiu-xiu;DU Ning;QIN Jiang;SUN Hai-yan;YUAN Yan-li;WU Jin-ling;HE Xiao-qing;WANG Jin-yun;HU YuanTANG Jin-shu;YU Hua-liang(Orthopaedic Institute of CP LA,The Fourth Medical Center of PLA General Hospital,Beijing,100048,China)

机构地区：[1]解放军总医院第四医学中心骨科,北京100048 [2]解放军总医院第四医学中心泌尿外科,北京100048

出　　处：《中国骨与关节杂志》2020年第11期864-868,共5页Chinese Journal of Bone and Joint

基　　金：解放军总医院临床科研扶持基金(2017FC-304M-TSYS-01)。

摘　　要：目的在脊髓损伤(spinal cord injury,SCI)患者膀胱功能诊断中应用我院自行研制的“膀胱安全测定装置”,评价其与尿流动力学检查所测相同参数之间的相关性方法。2018年1月至2019年8月,我院共收治40例SCI后神经源性膀胱患者,其中男32例,女8例;年龄19〜74岁,平均(42.10±12.90)岁。所有患者入院后经实验室及生化检查排除上尿路积水、尿路感染及结石等并发症,使用膀胱安全测定装置和尿流动力学检查,均记录膀胱顺应性、膀胱安全容量和膀胱分型,对数据资料进行整理分析结果40例SCI患者经膀胱安全测定装置检查将膀胱分型:I型9例,II型11例,III型11例,IV型9例;尿流动力学检查将膀胱分型:I型7例,II型12例,III型13例,IV型8例:两组分型判断的一致性Kappa系数为0.701,一致性良好,两组差异无统计学意义(P>0.05)「膀胱安全测定装置检查膀胱顺应性:低22例,正常15例,高3例;尿流动力学检查:低27例,正常12例,高1例,两组顺应性判断的一致性Kappa系数为0.757,—致性良好,两组差异无统计学意义(P>0.05)o膀胱安全测定装置检查膀胱安全容量均值为376.15 ml,尿流动力学检查膀胱安全容量均值为375.30 ml,两组差异无统计学意义(P>0.05)。结论膀胱安全测定装置在SCI患者膀胱功能诊断中所测量的膀胱顺应性、膀胱分型以及膀胱安全容量均与尿流动力学检查所测相同参数差异无统计学意义,在评定膀胱顺应性、膀胱分型方面一致性良好’该装置携带方便,适宜临床推广应用。Objective To evaluate the correlation between bladder safety measurement device and urodynamic exami nation in the diagnosis of bladder functions in patients with spinal cord injury(SCI).Methods From January 2018 to August 2019,40 cases with neurogenic bladder after spinal cord injury were treated in our hospital,including 32 males and 8 females with an average age of(42.10±12.90)years(range:19-74 years).After admission,all patients were excluded from complications such as upper urinary tract hydrops,urinary tract infection and calculus by laboratory and biochemical exami nations.Bladder safety measureme nt device and urodynamic examination were used.Bladder compliance,bladder safety capacity and bladder classification were recorded for analysis.Results Bladder types of 40 SCI patients were classified by bladder safety measurement device:type I 9 cases;type II II cases;type III II cases;type IV 9 cases.Urodynamic examination:type I 7 cases;type II 12 cases;type II 13 cases;type IV 8 cases.The Kappa coefficient of the judgment consistency of the two components was 0.701,showing good consistency with no significant differences between the two groups(P>0.05).Bladder compliance was checked by bladder safety measurement device:low in 22 cases;normal in 15 cases;high in 3 cases.Urodynamic examination:low in 27 cases;normal in 12 cases;high in 1 case.The Kappa coefficient of the judgment consistency of the two comp on ents was 0.757,showing good consistency with no sign ificant differences in compliance betwee n the two groups(P>0.05).Bladder safety measurement device showed the bladder capacity mean value was 376.15,while urodynamic examination 375.30.No significant differences were noted between the two groups(P>0.05).Conclusions Bladder compliance,classification and safety capacity measured by bladder safety measurement device are not statistically different from those measured by urodynamics in the diagnosis of bladder functions in SCI patients with good consistency.It is portable and convenient so that personalize

关 键 词：脊髓损伤 膀胱 神经原性 设备和供应 康复 

分 类 号：R493[医药卫生—康复医学] R651.2[医药卫生—临床医学]