液桥试验在诊断膀胱出口梗阻中的作用

目的：探讨液桥试验测定最小尿道开放压在诊断膀胱出口梗阻（BOO）中的作用。方法：对56例前列腺增生（BPH）患者行尿动力学检查，根据压力－流率测定结果分为梗阻组和非梗阻组。采用三种方法确定最小尿道开放压：（1）液桥试验直接测定，表示为Pmuo；（2）以尿流开始时的逼尿肌压（Pdet.open)估计；（3）以尿流停止时的逼尿肌压（Pdet.clos）估计。结果：56例患者平均Pdet.open＞Pmuo＞Pdet.clos，梗阻组Pmuo显著高于非梗阻组，差别有显著性意义。Pmuo值与尿道阻力因子（URA）、直线被动尿道阻力关系分级（LinPURR)呈显著正相关。结论：液桥试验直接测定最小尿道开放压克服了尿流延迟和盆底活动的影响，在诊断BOO方面有一定价值，可以作为压力－流率测定的辅助手段。

Fluid bridge test in the diagnose of bladder outlet obstruction

Objective To assess the value of fluid bridge test in diagnosing bladder outlet obstruction (BOO) by measuring directly the minimal urethral opening pressure. Methods 56 patients with BPH underwent urodynamic tests. According to the results of pressure-flow studies, they were divided into obstructive and unobsructive group. Minimal urethral opening pressure was determined in three ways:(1)Measured directly by fluid bridge test (Pmuo).(2)Estimated by Pdet.open. (3)Estimated by Pdet.clos. Results The mean Pmuo was statistically lower than Pdet.open but higher than Pdet.clos in two groups or in all 56 patients. Pmuo was much higher in the obstructive group. There was significant positive correlation between Pmuo and urethral resistance factor(URA);between Pmuo and linear passive urethral relation (LinPURR). Conclusions Using fluid bridge test to measure Pmuo is not affected by flow-lag or muscular activity in the pelvic floor.It should be taken as a complementary means for pressure-flow study in diagnosing BOO.