56例中年女性尿失禁患者的尿流动力学分析

目的 研究中年女性(35～55岁)尿失禁患者的尿流动力学变化,提高相应诊治水平.方法 对56例尿失禁的中年女性患者进行尿流动力学研究,并与正常对照组(17例)比较.结果 56例患者中压力性(SUI)尿失禁患者为33例(58.93％)(SUI组)、急迫性(UUI)尿失禁患者为9例(16.07％)(UUI组)、混合性(SUI/UUI)尿失禁患者为14例(25.00％)(SUI/UUI组).SUI组患者最大尿流率(Qmax)(27.72±5.21)ml/s高于正常对照组(20.45±7.15)ml/s,差异有统计学意义(P＜0.05)；UUI组的膀胱初感容量(FS)、正常排尿感觉(ND)、强烈排尿感觉(SD)、急迫排尿感觉(UD)与正常对照组[(135.65±42.73)ml与(132.70±40.65)ml、(166.24±51.42)ml与(160.70±50.44)ml、(315.75±42.34)ml与(320.75±42.34)ml、(320.24±45.03)ml与(335.75±51.98)ml]比较差异均有统计学意义(P均＜0.05)；SUI组及SUI/UUI组患者测得Valsalva漏尿点压力(ALPP)[(62.29±25.40)cm H2O与(88.30±28.54)cm H2O]比较差异有统计学意义(t=13.041,P＜0.05)；SUI组患者的最大尿流率时逼尿肌压(Pdet-Qmax)、最大尿道压(MUP)及最大尿道闭合压(MUCP)明显低于正常对照组[(24.29±6.24)cm H2O与(34.45±8.20)cm H2O、(68.20±18.27)cm H2O与(87.14±17.26)cm H2O、(74.24±35.75)cm H2O与(90.66±30.10)cm H2O]差异均有统计学意义(P均＜0.05).结论 中年女性尿失禁患者具有较大患者群体,其分类较为复杂,尿流动力学检查对于明确其诊断及选择正确治疗方法,提高疗效具有重要指导意义.

Urodynamic analysis on 56 cases of middle-aged female patients with urinary incontinence

Objective To study the changes of urodynamics of middle-aged(35-55 years old)female patients with urinary incontinence and improve the diagnosis and treatment.Methods Analyze and compare the urodynamics between 56 cases of middle-aged female patients with urinary incontinence and 17 cases of normal control.Results Among the 56 patients,33 cases with stress incontinence(SUI group 58.93％),9 cases with urgency urinary incontinence(UUI group 16.07％),14 cases with mixed urinary incontinence(SUI/UUI group 25.00％).There was significant difference on maximum flow rate(Qmax[27.72 ± 5.21]ml/s vs[20.45 ±7.15]ml/s,P ＜0.05)between the SUI group and control group.The beginning of a sense of capacity(FS),normal urination feeling(ND),strong feeling of urination(SD)and urgent urination feeling(UD)were (135.65 ± 42.73)ml,(166.24 ± 51.42)ml,(315.75 ±42.34)ml,(320.24 ± 45.03)ml and(132.70 ±40.65)ml,(160.70 ± 50.44)ml,(320.75 ± 42.34)ml,(335.75 ± 51.98)ml in the UUI group and control group respectively.And there were significant differences on the four indexes between UUI group and control group(P ＜ 0.05).There was significant difference on ALPP([62.29 ± 25.40]cm H2O vs[88.30 ± 28.54]cm H2O,P ＜0.05)between the SUI group and SUI/UUI group.Pressure at maximum flow rate(Pdet-Qmax,[24.29 ± 6.24]cm H2O vs[34.45 ± 8.20]cm H2 O,maximum urethral pressure(M UP([68.20 ± 18.27]cm H2O vs[87.14 ± 17.26]cm H2O)and maximum urethral closure pressure(MUCP([74.24 ±35.75]cm H2O vs[90.66 ±30.10]cm H2O)in SUI group were significantly lower than those in control group(P ＜0.05)Conclusion There were large groups of middle-aged female urinary incontinence in patients and the classification is more complex.It shows important guiding significance for diagnosis and selecting proper treatments by detecting urodynamic.