气态尿道压测定提高女性膀胱出口梗阻的诊断准确率  

Urethral pressure profile with air-charged system can improve the diagnostic accuracy of bladder outlet obstruction in female patients

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

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,北京100020

出　　处：《现代泌尿外科杂志》2022年第9期737-740,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：目的探讨应用基于气态测压系统的尿道压测定方法判断在压力-流率检查(PFS)中无法排尿女性患者是否存在膀胱出口梗阻(BOO)的诊断价值。方法对2021年1月—2021年12月于北京朝阳医院因下尿路症状(LUTS)行尿动力学检查的224例女性患者资料进行回顾性分析。所有患者由同一名医生应用基于气态测压系统的T-DOC尿动力测压导管完成PFS检查及尿道压测定,比较两种方法在诊断女性BOO中的相关数据。结果纳入的224名女性患者平均年龄(53.70±15.76),72.32%患者(162例)完成了完整PFS检查,98.66%的患者(221例)完成尿道压测定,表明尿道压测定完成率高于PFS。以压力-流率测定标准共判断出BOO患者98例,占总人数的43.75%(98/224),在完成PFS的162例患者中,这一数据为60.5%(98/162)。根据尿道压图形判定98例患者结果同样显示BOO,说明尿道压测定判断BOO的结果与金标准PFS高度一致。在纳入的全部224例患者中,64.28%的患者(144例)以尿道压测定标准判断并通过后续临床治疗证实为BOO,仅计算在完成尿道压力测定的221例患者,该占比则为65.1%(144/221),这表明与PFS相比尿道压测定对于女性BOO的总体诊断率更高(43.75%VS.64.28%)。进一步分析未能完成PFS的62例患者,其中以尿道压测定辅助诊断且最终诊断BOO的患者46例,占比为74.2%(46/62),说明PFS导致部分BOO患者被漏诊,而采用尿道压测定可使这部分患者中接近四分之三的人获得诊断。结论应用气态测压系统的压力-流率测定联合尿道压测定可以提高女性BOO患者的诊断率,尿道压测定对于无法完成PFS排尿期的女性BOO患者具有较好的辅助诊断价值。Objective To investigate the diagnostic value of urethral pressure profile(UPP)with air-charged system to determine the presence of bladder outlet obstruction(BOO)in female patients who were unable to urinate during pressure-flow study(PFS).Methods In this retrospective study,female patients who underwent UDS for lower urinary tract symptoms(LUTS)during Jan.2021 and Dec.2021 at our hospital were enrolled.PFS and UPP were performed by the same physician.The similarities and differences of two urodynamic methods in the diagnosis of BOO were compared.Results A total of 224 female patients with a mean age of 53.70±15.76 years were enrolled,162/224 of whom(72.32%)completed PFS and 221/224(98.66%)completed UPP,which indicated that UPP had a higher completion.BOO was detected in 98/224 cases(43.75%)by PFS,accounting for 60.5%(98/162)of those who completed PFS.These 98 cases were confirmed by UPP,which indicated that the UPP result was highly consistent with that of PFS.BOO was detected in 144 patients by UPP,accounting for 65.1%(144/221)of those who completed UPP.Compared with PFS,UPP had a higher overall diagnosis rate of BOO(43.75%vs.64.28%).Further analysis of the 62 patients who did not complete PFS showed that 46(74.2%)were diagnosed with BOO as an adjunct to UPP(46/62),indicating that PFS could lead to a missed diagnosis,and UPP could increase the diagnosis rate by approximately 74.2%.Conclusion The application of PFS combined with UPP with air-charged system can improve the diagnostic rate of female BOO patients,and UPP is a good diagnostic aid for BOO patients unable to complete the voiding phase of PFS.

关 键 词：下尿路症状 膀胱出口梗阻 压力-流率测定 气态测压系统 尿道压测定 

分 类 号：R69[医药卫生—泌尿科学]