尿动力学检查在压力性尿失禁诊疗中的应用价值

Clinical value of urodynamic examination in diagnosis and treatment of stress urinary incontinence

目的探讨尿动力学检查在压力性尿失禁诊疗中的应用价值。方法女性压力性尿失禁患者100例,经闭孔尿道中段无张力悬吊术(TVT-O)治疗。所有患者术前和术后6个月均行尿动力学检查,并填写国际尿失禁咨询委员会问卷简表(ICIQ-SF),统计主观治愈率,分析尿动力学主要参数的变化。结果术后6个月的主观治愈率为87.0%,改善率为10.0%,失败率为3.0%。ICIQ-SF评分显示,与术前比较,术后尿失禁症状改善[(18.5±3.4)分vs.(3.8±1.8)分](P<0.05)。术前最大尿流率和膀胱出口梗阻指数分别为(29.6±8.2)ml/s和-20.4±14.7,术后改善为(20.4±5.7)ml/s和-33.6±20.6(P<0.05)。而术后其他尿动力学指标无明显改变(P>0.05)。结论尿动力检查是判断尿失禁类型和评估TVT-O手术近期疗效的有效手段。

Objective To explore the clinical significance of the urodynamic examination in the diagnosis and treatment of the patients with stress urinary incontinence（SUI）.Methods The tension free vaginal tape obturator（TVT-O）surgery was performed in 100 wemen with SUI.The illness state was evaluated with ICIQ-SF（the Questionnaire Short Form of the International Urinary Incontinence Advisory Committee）before and 6 months after TVT-O surgery.Results The subjective cure rate was 87.0%,the improvement rate was 10.0%,and the failure rate was 3.0% in 6 months after operation.Compared with before,ICIQ-SF scores of SUI decreased significantly after surgery[（18.5±3.4）points vs.（3.8±1.8）points]（P〈0.05）.Compared with before,the maximum flow rate and bladder outlet obstruction index were significantly decreased after surgery[（20.4±5.7）ml/s vs.（29.6±8.2）ml/s and-33.6±20.6vs.-20.4±14.7]（P〈0.05）.The rest urodynamic parameters were not significantly changed after operation compared to before（P〈0.05）.Conclusion The urodynamic examination is a effective measure in differentiating the type of urinary incontinence and avaluating the efficacy of treatment.