瓣膜膀胱综合征尿动力学研究

Urodynamics of valve bladder syndrome

目的 探讨瓣膜膀胱综合征(VBS)患儿的尿动力学表现及其意义。方法 16 例男性后尿道瓣膜电切术后患儿,年龄平均(3.2±1.8)岁。分为2组,全部患儿均在2岁前行后尿道瓣膜电切术。第一组7例,平均年龄(1.6±0.3)岁,术后至尿动力学检查间隔时间小于1 年。第二组9 例,平均年龄(4.5±1.2)岁,间隔时间大于1年,平均(3.5±1.3)年。对比两组尿动力学结果。结果 第二组最大逼尿肌收缩压(Pdet.max)和膀胱顺应性(BC)分别为(56.2±14.1) cmH2 O和(12.5±7.4)ml/cmH2O,低于第一组Pdet.max(95.1±18.3 ) cmH2 O和BC(52.4±26.9) ml/cmH2 O;第二组残余尿量(PVR)和最大膀胱容量(MBC)分别为(96.6±52.4) ml 和(217.4±61.7) ml,大于第一组PVR(42.8±38.9) ml和MBC(138.1±20.1) ml,差异有统计学意义(P<0.05)。两组分别有4 例和2例有逼尿肌不稳定(DI),Fisher’s精确概率检验两者差异无统计学意义(P>0.05)。在第二组中2例逼尿肌无收缩,有4 例出现较特殊的排尿,表现为逼尿肌收缩波不光滑, 该4 例Pdet.max平均(62.3±9.1) cmH2O,PVR平均(87.5±41.9) ml。结论 VBS膀胱功能异常多发.年龄较大患儿逼尿肌功能较年龄较小患儿差。尿动力学检查能及时发现膀胱功能异常和指导下一步治疗。因此,所有PUV患儿均应行该检查以了解膀胱功能,

Objective To investigate the urodynamic characteristics of valve bladder syndrome (VBS).Methods Sixteen children with VBS were were divided into two groups: those who underwent urethral valve fulguration within a year and those beyond a year. The urodynamic results were compared between two groups.Results In group two,the Pdet.max and BC were ( 56.2± 14.1)cmH 2O and ( 12.5± 7.4)ml/cmH 2O respectively,lower than Pdet.mas ( 95.1± 18.3)cmH 2O and BC( 52.4± 26.9)ml/cmH 2O in group one.In group two,the PVR and MBC wre ( 96.6± 52.4)ml and ( 217.4± 61.7)ml respectively,higher than PVR ( 42.8± 38.9)ml and MBC ( 138.1± 20.1)ml in group one.Difference in these four parameters between two groups was significant (P< 0.05),while there was no difference in DI (P> 0.05).In group two,intermittent detrusor contraction, a relatively special pattern was found in four cases,in which Pdet.max and PVR were averagely ( 62.3± 9.1)cmH 2O and ( 87.5± 41.9)ml respectively.Conclusions VBS may present with multiple bladder dysfunctions and require urodynamic study to evaluate the function. Pdet.max and BC decreases PVR and MBC increase as the patients grow older.