腰间盘突出的压迫时间对膀胱功能的影响

Impact of disease duration of lumbar disk herniation on bladder dysfunction

目的研究腰椎间盘突出的压迫时间对膀胱功能的影响。方法对85例腰椎间盘突出症患者的尿动力学检查结果进行回顾性分析。根据腰椎间盘突出的病程将患者分为3组，即A（〈1年，26例）、B（1-5年，31例）和C（〉5年，28例）组，比较各组间的尿动力学检查结果。结果3组的残余尿量分别平均为A组50ml，B组80ml，C组120ml；最大膀胱容量分别平均为A组（375±147）ml，B组（481±184）ml，C组（562±173）ml；3组间差异均有统计学意义（P=0．000，0，030），各两组间差异亦均有统计学意义（均P〈0．05）。3组的初始尿意容量分别平均为A组（220±88）ml，B组（247±132）m1，C组（356±199）ml，3组间差异有统计学意义（P=0．036），但A组与B组间差异无统计学意义（P〉0．05），而其他两组间差异均有统计学意义（P=0．010，0．017）。3组的最大尿流率、最大逼尿肌压力和膀胱顺应性比较，差异均无统计学意义（均P〉0．05）。结论腰椎间盘突出的病程对膀胱功能产生影响，膀胱功能减退随着腰椎间盘突出病程的延长而加重。

Objective To analyze the association between the disease duration and bladder dysfunction in lumbar disk herniation patients. Methods The urodynamie parameters of 85 lumbar disk herniation patients with different disease duration, 26 with the duration 〈1 year （ Group A）, 31 with the duration of 1 - 5 years （ Group B）, and 28 of the duration 〉 5 years （ Group C）, were retrospectively analyzed. Results The average post-voiding residual volume of Group A was 50 ml, significantly lower than those of Groups B and C （80 ml and 120 ml respectively, both P 〈0.05） with significant difference between Groups B and C too （P 〈0.05）. The average maximum cystometric capacity of Group A was （375±47） ml, significantly higher than those of Groups B and C [ （481±184）inl and（562±173 ）ml respectively, both P 〈 0.05] and there was significant difference between Groups B and C too （ P 〈 0.05 ）. The average volume at the first desire to void of Group A was （220±88） ml, significantly lower than those of Groups B and C [（247±132） ml and （356±199） ml respectively, both P 〈0. 05], however, there was no significant difference between Groups A and B （P 〉 0.05 ）. There were no significant differences in the maximum flow rate, maximum detrusor pressure, and bladder compliance among the three groups （ all P 〉 0.05）. Conclusion Prolonged disease duration of lumbar disk herniation worsens the bladder function.