压力-流率测定中应用气态和液态测压系统结果的异同

目的探讨压力-流率测定(PFS)中应用气态测压系统(ACC)和液态测压系统(WFC)在操作流程、测量数据、结论及相关指标压力读数方面的异同。方法本研究为前瞻性同步对照研究,选取2021年1—3月于北京朝阳医院行PFS的患者。纳入标准:①因尿频、尿急、尿失禁、排尿困难等下尿路症状需行PFS的患者;②年龄≥18岁。排除标准:①无法进行或无法配合尿动力学检查者;②有严重尿道狭窄、急性期泌尿系感染者;③妊娠期妇女。PFS应用7FDR T-DOC®AC三腔膀胱测压管,外接气态传感器和改良液态压力传导模块,持续性测定膀胱内气态传导压力,同时应用7FA T-DOC®AC单腔直肠测压管和7F LABORI-CAT411双腔水囊腹压测压管,分别测定直肠内气态传导压力和液态传导压力。记录并比较WFC与ACC于初始坐位、膀胱充盈(100、150、200ml)、咳嗽、排尿期最大尿流率(Qmax)、排尿期最大逼尿肌压力、排尿结束时测量的逼尿肌压力(Pdet)、腹压(Pabd)和膀胱内压(Pves)的异同。结果本研究共纳入63例患者,男37例,女26例。平均年龄59.2(25~86)岁。膀胱充盈期,ACC和WFC于初始坐位以及膀胱充盈100、150、200 ml时测量的Pves平均值分别为30.78 cmH2O(1 cmH2O=0.098 kPa)和24.67 cmH2O、29.79 cmH2O和25.13 cmH2O、30.87 cmH2O和25.90 cmH2O、30.95 cmH2O和26.17 cmH2O,Pabd平均值分别为30.03 cmH2O和24.17cmH2O、28.81 cmH2O和21.78cmH2O、28.89 cmH2O和21.38cmH2O、28.44 cmH2O和21.60 cmH2O,差异均有统计学意义(P<0.01)。排尿期,ACC和WFC测量的Pdet差异无统计学意义(P>0.05),且两个系统的数据一致性好。咳嗽时,ACC和WFC测量的Pves(57.30 cmH2O和49.95cmH2O)、Pdet(54.21 cmH2O和43.10 cmH2O)差异有统计学意义(P<0.01),但两个系统的数据具有强线性相关关系(Pves:R2=0.792;Pabd:R2=0.756)。Bland-Altman分析结果显示,两个系统测量最大尿流率时Pdet的95%CI-13.9~15.8 cmH2O,平均差值0.9 cmH2O,说明一致性良好。结论PFS充盈期膀胱测压时,ACC测量数值高于WFC,但无临床意义;排尿期测量结果提示,两个测压系统判断逼尿肌收缩力和膀胱出口梗阻程度的结论有高度一致性。

液态和气态测压传导系统在尿动力学检查应用中的差异

尿动力学检查从多个方面再现患者排尿状态、评估患者下尿路功能,为临床诊疗提供依据。尿动力检查过程中,液态测压传导系统应用较广泛,已形成国际公认标准,但同时也存在易产生赝像、操作复杂等问题。气态测压系统作为一种较新的技术应用较少,尚无全球统一的技术标准,但因其具有操作简便、卫生等优势,在临床中也已经得到较广泛的应用。本文通过文献复习,从设备特点、压力-流率测定、尿道压力测定、安全性4个方面探讨液态测压传导系统和气态测压传导系统之间的差异及其可能原因,为今后两种尿动力检查测压系统更广泛的临床应用提供根据。

A graphic monitoring method for electric power of VVVF hydraulic system

In order to online monitor the running state of variable voltage and variable frequency(VVVF)hydraulic system,this paper presents a graphic monitoring method that fuses the information of variable frequency electric parameters.This paper first analyzes how the voltage and current of the motor stator change with the operation conditions of VVVF hydraulic system.As a result,we draw the relationship between the electric parameters(voltage and current)and power frequency.Then,the signals of the voltage and current are fused as dynamic figures based on the idea of Lissajous figures,and the values of the electric parameters are related to the features of the dynamic figures.Rigorous theoretical analysis establishes the function between the electric power of the variable frequency motor(VFM)and the features of the plotted dynamic figures including area of diagram,area of bounding rectangle,tilt angle,etc.Finally,the effectiveness of the proposed method is verified by two cases,in which the speed of VFM and the load of VVVF hydraulic system are changed.The results show that the increase of the speed of VFM enhances its three-phase electric power,but reduces the tilt angle of the plotted dynamic figures.In addition,as the load of VVVF hydraulic system is increased,the three-phase electric power of VFM and the tilt angle of the plotted dynamic figures are both increased.This paper provides a new way to online monitor the running state of VVVF hydraulic system.