妇科下尿路功能障碍141例尿动力学分析

Urodynamic analysis of the female lower urinary tract dysfunction

目的探讨尿动力学在妇科下尿路功能障碍检查中的应用价值。方法对2009年1月至2010年9月我院141例下尿路功能障碍的妇科患者进行尿动力学检查,其中尿失禁106例,排尿困难14例,尿频21例。结果 106例尿失禁患者中,10例膀胱过度活动,42例未诱导出漏尿,22例膀胱流出道Linp-URR图示梗阻;14例排尿困难的患者中,1例膀胱过度活动,2例逼尿肌收缩乏力,5例检出漏尿,7例膀胱流出道Linp-URR图示无梗阻;21例尿频患者中,6例膀胱过度活动,4例顺应性欠佳,8例漏尿,无逼尿肌收缩乏力病例,5例膀胱流出道Linp-URR图示梗阻。尿失禁组患者的膀胱容量和最大尿流率明显高于排尿困难组和尿频组(P<0.05)。结论根据尿动力学检查结果有助于诊断并明确妇科下尿路功能障碍产生的原因。

Objective To investigate the value of urodynamic checks on the female lower urinary tract dysfunction （LUTD）. Methods Urodynamic checks were applied on 141 female patients with LUTD. Among them there were 106 cases with incontinence, 14 cases with dysuria, and 21 cases with frequency and urgency. Results Among the 106 cases with incontinence, 10 had overactive bladder, 42 didn＇t found urine leak, 22 showed obstruction based on Linearized passive urethral resistance relation （Linp-URR） figure. Among the 14 cases with difficulty of urination, 1 had overactive bladder, 2 had detrusor instability, 5 had urine leak, and 7 showed non-obstruction based on Linp-URR figure. Among the 21 cases with difficulty of uri- nation, 6 had overactive bladder, 4 had low bladder compliance, 8 had urine leak, none had detrusor instability, and 5 showed obstruction based on Linp-URR figure. The capacity and peak flow rate in urinary incontinence group were significantly higher than that in hesitancy and frequency groups （P〈0.05）. Conclusion Urodynamic checks may contribute to diagnosis and find- ing out the cause of female LUTD.