尿流动力学检查在成年女性膀胱过度活动症诊断中的应用

摘要

目的 探讨尿流动力学检查在成年女性膀胱过度活动症诊断中的应用价值.方法 2013年9月到2017年2月选择在承德医学院附属医院诊治的成年女性膀胱过度活动症患者78例作为观察组,同期选取在该院行尿流动力学检查但结果正常的成年女性78例作为对照组,记录两组的常规检查、尿动力学检查与充盈期膀胱压检查结果,并进行相关性分析.结果 观察组的国际前列腺症状评分(IPSS)高于对照组,生活质量评分(QOL)低于对照组(P＜0.05).观察组的日间排尿次数、夜间排尿次数与对照组对比差异有统计学意义(P＜0.05).观察组的最大尿流率(Qmax)值都低于对照组,最大膀胱容量(MBC)与残余尿量(PVR)值高于对照组(P＜0.05),两组最大排尿压(MVP)值对比差异无统计学意义(P＞0.05).观察组的B1、B2与逼尿肌压力(Pdet)值分别为(13.44 ±3.29)mL/cmH2O、(18.22 ±4.21)mL/cmH2O和(20.65 ±4.51)cmH2O,都明显低于对照组的(31.33 ±4.19)mL/cmH2O、(40.20 ±5.29)mL/cmH2O 和(30.89 ±5.82)cmH2O(P ＜0.05).直线相关分析显示观察组的日间排尿次数、夜间排尿次数与IPSS评分、PVR、MBC 值呈明显正相关(P＜0.05),与QOL评分、Qmax、B1、B2、Pdet值呈明显负相关(P＜0.05).结论 尿流动力学可以客观动态地观察成年女性膀胱过度活动症患者的尿道功能,充盈期膀胱压检查可有效反映患者的膀胱顺应性,两者联合使用都可反映患者的临床症状,有利于进行疾病诊断.%Objective To evaluate the diagnostic significance of urodynamics in overactive bladder in female a -dults.Methods From September 2013 to February 2017, 78 adult females with overactive bladder in our hospital were selected as the observation group , and 78 health adult females with urodynamic examination were selected as the control group at the same period.Routine examination, urodynamics examination and filling bladder pressure examination were re-corded.Results The IPSS score in the observation group was significantly higher than that of the control group , and the QOL score was significantly lower than that of the control group ( P＜0.05).There were significant differences between the observation group and the control group in the daytime urination and nocturnal urination (P＜0.05).The Qmax value in the observation group was significantly lower than that of the control group , and the MBC and PVR values were signifi-cantly higher than those of the control group (P＜0.05).There was no significant difference in MVP value between the two groups (P＞0.05).The B1, B2 and Pdet values in the observation group were 13.44 ±3.29 mL/cmH2O, 18.22 ± 4.21 mL/cmH2O and 20.65 ±4.51 cmH2O, respectively, which were significantly lower than those of the control group (31.33 ±4.19)mL/cmH2O, 40.20 ±5.29 mL/cmHO2and 30.89 ±5.82 cmH2O, respectively, P＜0.05).Linear cor-relation analysis showed that the daytime urination and nocturnal urination were significantly positively correlated with IPSS score, PVR and MBC values (P＜0.05), and significantly negatively correlated with QOL score , Qmax, B1, B2, and Pdet values (P＜0.05).Conclusion The urodynamics can objectively reflect the dynamic urethral function in the diag-nosis of overactive bladder in female adults , and the filling bladder pressure can effectively reflect the bladder compliance . The combined use of the both technique can reflect the clinical symptoms of the overactive bladder .