基于气态传导测压系统的尿动力学检查在女性膀胱出口梗阻疾病诊断中的应用  

Experiences of urodynamic study with air-charged systems in female bladder outlet obstruction

作　　者：王菲 张朝华[1] 常冉 周飞 郭伟[1] 张建忠[1] 张鹏[1] WANG Fei;ZHANG Chaohua;CHANG Ran;ZHOU Fei;GUO Wei;ZHANG Jianzhong;ZHANG Peng(Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020

出　　处：《现代泌尿外科杂志》2022年第9期733-736,共4页Journal of Modern Urology

基　　金：北京市属医院科研培育计划项目(No.PX2021014)。

摘　　要：目的探讨以T-DOC气态传导测压系统为基础的尿动力学检查(尤其是气态传导系统对尿道压描记功能)在女性膀胱出口梗阻(BOO)中的诊断价值。方法回顾性分析首都医科大学附属北京朝阳医院2020年9月-2021年5月收治的213例女性BOO患者的资料临床(共纳入279例女性患者,均因下尿路功能障碍就诊,排除泌尿系感染、神经源性膀胱以及明显解剖异常患者,均无下尿路功能疾病手术史。所有患者均应用气态传导测压系统为基础的尿动力学检查,其中213例患者最终诊断为BOO),平均年龄(53.9±14.9)岁,分析此213例患者的尿动力检查结果。结果确诊BOO患者共213例,占全部入组患者的76.3%,其中膀胱颈梗阻93例,尿道远端狭窄57例,尿道括约肌痉挛63例。排尿过程中带测压管未能排尿患者54/213(25.35%)例,通过尿道测压静态尿道压曲线描记,明确BOO病因为膀胱颈梗阻6例,尿道远端狭窄12例,尿道括约肌痉挛36例。结论以气态传导系统为基础的尿动力检查,应用压力-流率测定结合静态尿道压曲线描记可对不同位置的BOO进行更准确的定性、定位及定量诊断,尤其气态传导系统的静态尿道压曲线描记对于那些排尿期带管无法排尿的患者可判断膀胱出口梗阻的具体位置,对于传统尿动力学检查方法是一种有益的补充。Objective To investigate and summarize the diagnostic value of urodynamic study(UDS)based on air-charged system(especially the function of air-charged system for urethral pressure profile)in female bladder outlet obstruction(BOO).Methods The clinical data of female BOO patients admitted to our hospital during Sep.2020 and May 2021 were retrospectively analyzed.A total of 279 patients were included,all of whom had lower urinary dysfunction.Exclusion criteria were urinary infection,neurogenic bladder,and obvious anatomical abnormalities,history of surgery for lower urinary dysfunction.All patients received UDS using air-charged system.Altogether 213 patients were confirmed,with a mean age of(53.9±14.9)years.The urodynamic results of these patients were analyzed.Results The final diagnosis of BOO was confirmed in 213 patients,accounting for 76.3% of all patients enrolled,including bladder neck obstruction in 93 cases,distal urethral stricture in 57 cases,and urethral sphincter spasm in 63 cases.In 54/213(25.35%)patients who failed to urinate with a manometry tube during voiding,the cause of BOO was clearly identified as bladder neck obstruction in 6 cases,distal urethral stricture in 12 cases,and urethral sphincter spasm in 36 cases by urethral manometry static urethral pressure curve tracing.Conclusion UDS based on the air-charged system,using pressure-flow study combined with static urethral pressure profile,can provide an accurate qualitative,localized and quantitative diagnosis of BOO in different locations.In particular,the static urethral pressure profile of the air-charged system is useful to determine the precise location of bladder outlet obstruction in patients who are unable to urinate with a tube during voiding.It is a useful complement for traditional urodynamic test.

关 键 词：尿动力学 膀胱出口梗阻 气态传导测压系统 尿道压测定 

分 类 号：R694.5[医药卫生—泌尿科学]