单一症状原发性夜遗尿患儿排尿后收缩观察

Study on post-voiding contraction in children with monosymptomatic primary nocturnal

目的 :初步探讨排尿后收缩 (PVC)在单一症状原发性夜遗尿 (primarymonosymptomaticnocturnalenuresis,PMNE)患儿发病中的意义。方法 :患儿共 6 5例 ,男 4 2例 ,女 2 3例 ,年龄 6～ 14 (9.4± 2 .2 )岁 ,无神经病变体征。通过耻骨上途径置入测压管进行自然灌注尿动力学检查 ,并测括约肌肌电图。结果 :有PVC 4 0例 (男 2 6例 ,女 14例 ,年龄 6～ 14 (9.5± 2 .2 )岁 ) ;无PVC 2 5例 (男 16例 ,女 9例 ,年龄 6～ 14 (9.1± 2 .3)岁 )。 2组患儿的膀胱最大容量(VMC)、膀胱顺应性 (BC)、残余尿量 (VPR)、逼尿肌不稳定 (DI)和逼尿肌括约肌协同失调 (DSD)发生率差异均无统计学意义 (P >0 .0 5 )。PVC表现可分为 3型 ,单峰平滑型 (Ⅰ型 ) 16例 ,单峰非平滑型 (Ⅱ型 ) 10例和多峰型 (Ⅲ型 ) 14例。结论 :PMNE患儿PVC与DI、MCC、PVR和BC的发生和改变无明显相关性。Ⅰ型和Ⅱ型PVC与DSD有关 ,Ⅲ型较为特殊 。

Aim: To investigate the incidence of PVC in children with monosymptomatic primary nocturnal(PMNE). Methods: A total of 65 children aged 6～14(9.4±2.2) years old (42 cases of male,23 cases of female) with PMNE were subjected to detect natural filling urodynamic and electromy gram. Results: 40 cases were found to be with PVC,and 25 cases were not. Three types of PVC were observed.Type Ⅰ(single smooth wave) in 16 children was related to a single detrusor-sphicter dyssynergia, type Ⅱ(single staccato wave) in 10 children was related to multiple dyssynergia, and type Ⅲ (multiple waves) in 14 children (35%) in which 13 children were observed dribbing after voiding. The differences in V MC,BC,V PR,DI,and DSD between children with PVC and those without were not significant (P>0.05). Conclusion: Type Ⅰ and Ⅱ of PVC are related to DSD. PVC might be not related to V MC,BC,V PR,and DI in PMNE.