儿童精神性尿频的尿动力学变化

目的 探讨儿童精神性尿频的病因、病理生理变化及其治疗。方法 本组38例，应用尿流动力仪分别记录排尿量、尿流曲线、膀胱压力容积及压力－流率－肌电图。结果 38例中，4例尿动力学安全正常；34例出现膀胱功能异常，占89.5%(34/38)，其中逼尿肌不稳定性收缩者12例，低顺应性膀胱者6例，低顺应性膀胱合并逼尿肌不稳定性收缩者16例；最大膀胱测量容量百分数下降14例。排尿期异常仅5.3%(2/38)，为尿道括约肌过度活跃。尿动力学检测后，84.2%的患儿症状完全消失或好转。结论 逼尿肌不稳定性收缩是最主要的病理生理学改变；排尿训练是主要治疗措施。

Urodynamic assessment of psychogenic urinary frequency in children

Objective The purpose is to investigate urodynamic change and treatment of psychogenic urinary frequency in children.Methods The urine retention and voiding in 38 children (22 boys,16 girls,mean age= 6.3 years) were calculated by uroflowmetry,standard slow filling cystometry and pressure flow electromyography urodynamic testing, and 16 patients also underwent 30 minutes interval cystometry.Results The urodynamic finding were categorized into 3 main patterns,(1) Detrusor instability contraction (DI, n =12);(2) low compliance (6);(3) DI with low compliance (16).The percentage of maximal bladder capacity was decreased in 14 patients. Only 2 patients ( 5.3% ) had hyperactivity urethral sphincter.After urodynamic study,the symptom of 84.2% patients disappeared or improved.Conclusions DI is the major patho physiological change associated with psychogenic urinary frequency.Bladder training is the main treatment.