膀胱压减去尿道出口压与最大尿流率比率测定诊断膀胱出口梗阻的临床价值

Clinical value for P_(ves)-P_o/Q_(max) determination in diagnosing BOO

目的:探讨膀胱压(P_(ves))减去尿道出口压(P_o)比最大尿流率(Q_(max))比率的测定(P_(ves)-P_o/Q_(max))对诊断膀胱出口梗阻(BOO)的可靠性。方法:采用WIEST尿动力学仪,53例患者分为逼尿肌低压低尿流率、高压高尿流率、高压低尿流率、高压伴正常尿流率、正常逼尿肌压伴正常尿流率5种不同排尿类型,应用P_(ves)-P_o/Q_(max)测定诊断BOO,同时应用ICS标准方法即P_(ves)减去腹压(P_(abd))比最大尿流率(Q_(max))的测定(P_(ves)-P_(abd)/Q_(max))诊断BOO;用两种方法判别BOO并进行自身对比。结果:18例逼尿肌低压低尿流率以及高压高尿流率患者,应用ICS标准方法P_(ves)-P_(abd)/Q_(max)测定不能明确诊断有否BOO,但应用P_(ves)-P_o/Q_(max)测定能明确诊断有否BOO;35例逼尿肌高压伴低尿流率或伴正常尿流率以及正常逼尿肌压伴正常尿流率的患者,应用两种方法诊断有否BOO结果基本一致。结论:应用P_(ves)-P_o/Q_(max)测定诊断BOO对各种排尿类型有普遍的可靠性,特别对逼尿肌低压低尿流率或高压高尿流率病例能明确判定有否BOO。

Purpose:To study the reliability of Pves-Po/Qmax determination in diagnosing BOO. Methods: Fifty three patients fell into 5 urination types including low flow resulted from low pressure of detrusor, high flow resulted from high pressure of detrusor, low flow accompanied by high pressure of detrusor, normal flow accompanied with high pressure of detrusor and normal flow accompanied with normal pressure of detrusor. Using WIEST uro-dynamics meter to diagnose whether there is BOO in these cases according to Pves-Po/Qmax determination and ICS standard method (Pves-Pobd/Qmax) respectively. Results from the two methods were compared. Results: In 18 casesith low flow resulted from low pressure of detrusor or high flow resulted from high pressure of detrusor, BOO was accurately identified using Pves-Po/Qmax determination but not the ICS standard method. In 35 cases with low flow accompanied by high pressure of detrusor, normal flow accompanied with high pressure of detrusor or normal flow accompanied with normal pressure of detrusor , results from two methods were roughly the same. Conclusions: It is universally reliable to apply Pves-Po/Qmax determination in diagnosing whether there is BOO in all urination-typed patients,especially true in the cases with low flow resulted from low pressure of detrusor or high flow resulted from high pressure of detrusor.