脑血管病所致排尿障碍46例

[背景 ]神经原性膀胱在临床工作中尚未引起足够重视 ,为此以脑血管病患者为对象进行了问诊及尿流动态研究以观察脑血管疾病对膀胱机能的影响 .[病例报告 ]对脑血管病患者进行排尿症状问诊 ,对 46例有排尿障碍症状者进行残尿、膀胱内压的测定、外括约肌肌电图以及对其波形的分析 .结果示 ,有排尿症状者占 78% ,其中储尿症状较多 ,有切迫性尿失禁者占 47% .对 11例有排尿症状者进行了尿流动态检测 ,其结果有残尿者 4例 ,残尿量为 5 0～ 10 0mL(平均 73mL) ,膀胱容量缩小 9例、增大 1例、正常 1例 ,逼尿肌过度反射 8例 ,球海绵体肌反射亢进 3例 ,排尿肌外括约肌协调不全 4例 .[讨论 ]脑血管病患者中近 80 %有排尿障碍 ,储尿、排尿两障碍并不少见 ,但以储尿障碍为主 .尿流动态检测结果示排尿障碍者的神经传导障碍主要由中枢神经障碍所致

Clinical observation in 46 cases of cerebrovascular diseases with dysuria

BACKGROUND The neurogenic bladder was not sufficient for recognition in clinic, therefore it was observed that the influence of cerebrovascular diseases to bladder function by asking the patients with cerebrovascular diseases and study of urinary dynamics. CASE REPORT The 46 cases of cerebrovascular diseases with dysuria were asked about urinate situation and examined for the residual urine, the inner pressure of bladder, the electroouter-sphinctrogram and its waves. To having micturition symptom was 78%, in which most of them had the symptom of urine reserve, and the urinary incontinence is 47%. The urinary dynamics were detected in 11 patients, in which 4 of remnants urine is 50～100 mL (average 73 mL), and 9 of bladder capacity reduced, 2 of bladder capacity increased and 1 was normal,and 8 patients had over reflex of detrusor urinae, 3 had sthenic reflex of bulbocavernous muscle and 4 had the detrusor-external sphincter dyssynergia. DISCUSSION 80% of patients with cerebrovascular diseases have dysuria and the uroschese and dysuria is not scarce, but the uroschese is main symptom. The results of urodynamic detection indicate that the nerve block in patients with dysuria is mainly caused by central nerve obstruction.