尿流动力学检查在女性压力性尿失禁诊断和治疗中的价值

Clinical value of urodynamic analyses in the diagnosis and therapy of the female stress urinary incontinence

目的分析压力性尿失禁患者的尿流动力学特点,探讨其在女性压力性尿失禁诊断和治疗中的临床价值。方法对临床诊断为压力性尿失禁的50例术前行尿流动力学检查,并与正常对照组(50例)比较;采用经闭孔无张力尿道中段悬吊术治疗前述50例女性压力性尿失禁,并与其中38例术后尿流动力学检查数据对照比较。结果压力性尿失禁组最大尿流率(Qmax)、平均尿流率(Qave)高于正常对照组,最大尿道闭合压(MUCP)、最大尿流率时逼尿肌压(Pdet-Qmax)低于正常对照组(P<0.05),行瓦尔萨尔瓦(valsalva)动作均可诱发漏尿,漏尿点压力(VLPP)为(60.84±23.14)cm H2O。50例术后症状明显改善,尿流动力学检测指标较术前最大尿流率有所下降,排尿时最大逼尿肌压和腹压漏尿点压力明显升高(P<0.05)。结论尿流动力学检查对压力性尿失禁的临床诊断及评价手术效果有重要价值。

Objective To evaluate the urodynamic characteristics of patients with stress urinary incontinence（SUI）,and investigate the clinical value of urodynamic findings in the diagnosis and treatment of SUI in female patients.Methods Patients with SUI underwent urodynamic examination prior to surgery,and then were compared with normal group.50 female patients with SUI underwent transobturator vaginal tape operation（TVTO） and their preoperative data were compared with the postoperative data in 38 patients.Results There were significant differences in the urodynamic parameters including maximal flow rate（Qmax）,average flow rate（Qave）,maximum uret hral closure pressure（MUCP） and pressure at the maximum flow（Pdet-Qmax）（P〈0.05）.In the SUI group,Valsalva leak point pressure（VLPP） was（60.84 ± 23.14） cm H2 O.The postoperative clinicalsymptoms of all the 50 cases were obvious improved.Pdet-Qmax and VLPP were significantly higher and Qmax was significantly lower after surgery（P〈0.05）.Conclusion Urodynamic study is of significant value in the diagnosis and evaluation of the effect of the treatment of SUI in female patients.