女性膀胱白斑患者电切术前后尿动力学检查的临床应用价值

Clinical significance of urodynamic study on female bladder leukoplakia patients with transurethral electroresection

目的探讨尿动力学检查在女性膀胱白斑患者电切术前后的临床应用价值。方法选取2014年9月-2016年1月该院经尿道电切术治疗的37例女性膀胱白斑患者,分别进行术前和术后3~6个月尿动力学检查。观察术前尿动力学检查和手术前后尿动力学变化的特点。结果 30例患者术前尿动力学检查异常,占全部患者的81.1%,主要表现为逼尿肌过度活动、膀胱感觉增强、膀胱出口梗阻及逼尿肌活动低下,发生率分别为32.4%(12/37)、21.6%(8/37)、16.2%(6/37)和10.8%(4/37),尿动力学表现呈多样化。患者电切术后最大尿流率、平均尿流率、最大膀胱容量及膀胱顺应性较术前增加,最大尿道闭合压力较术前降低,差异有统计学意义(P<0.05);手术前后最大逼尿肌压力、最大尿流率时逼尿肌压力、功能性尿道长度比较,差异无统计学意义(P>0.05)。结论女性膀胱白斑患者多数同时存在下尿路排尿功能障碍,尿动力学检查对患者手术前后下尿路功能的评估、手术疗效的判断、辅助治疗的应用具有指导意义。

Objective To investigate the clinical significance of urodynamic study on female bladder leukoplakia patients with transurethral electroresection. Methods Thirty-three female bladder leukoplakia patients who underwent transurethral electroresection surgery from September 2014 to January 2016 were selected. The urodynamic changes of these patients were retrospectively analyzed. Results According to the urodynamic results, 81.1% of the patients suffered from detrusor overactivity, increase of bladder sensation,bladder outlet obstruction and detrusor underactivity, and their incidences were 32.4%（12/37）, 21.6%（8/37）,16.2%（6/37） and 10.8%（4/37） respectively. Compared to preoperative urodynamic results, the maximum flow rate, average flow rate, maximum cystometric capacity and bladder compliance were increased, and the maximum urethral closure pressure was reduced after operation, the differences were statistically significant（P〈0.05）. The maximum detrusor pressure, detrusor pressure at maximum flow rate and functional urethral length before and after operation were not statistically different（P〉0.05）. Conclusions Most of female bladder leukoplakia patients have lower urinary voiding dysfunction. The urodynamic tests are of great significance in evaluation of lower urinary tract function before and after surgery, estimation of surgical curative effect and application of adjuvant therapy.