女性下尿路症状的尿动力学分析(附283报告)

目的 研究以下尿路症状为主诉的女性患者的尿动力学变化及其临床意义。方法女性患者．年龄6-89岁，临床表现为储尿期（刺激性）和（或）排尿期（梗阻性）症状，采用尿动力学方法检查尿流率、同步膀胱压力容积流率及肛门括约肌肌电图测定、部分同步透视下行影像尿动力学检查。结果 以排尿症状为主者86例，以储尿症状为主者197例。不稳定膀胱57例，感觉性尿急30例。神经原性膀胱尿道功能障碍32例，其中逼尿肌反射低下26例。逼尿肌反射亢进7例。逼尿肌收缩力低下26例。逼尿肌外括约肌协同失调1例。下尿路梗阻30例，其中膀胱颈梗阻6例，尿道远端狭窄11例，非神经原件逼尿肌外括约肌协同失调13例。压力性尿失禁68例，其中Ⅰ型19例，Ⅱ型12例。Ⅲ型14例，Ⅱ／Ⅲ型23例；TF常40例。结论 尿动力学检查能了解膀胱的功能状况和膀胱出口梗阻的部位，为临床治疗的选择提供了可靠的依据。

Urodynamic analysis of lower urinary tract symptoms in females(report of 283 cases)

Objective To investigate the causes and clinical significance of lower urinary tract symptoms (LUTS) in females with urodynamic studies. Methods 283 females (mean age 42.8 years, ranging from 6 to 89) with LUTS were evaluated with urodynamic examination. Results 86 cases had urination difficulties, and 197 storage dysfunction. 57(20.1%) had unstable bladder, and 30(10.6%) sensory urgency. 32 (11.3%) patients had neurogenic bladder, among whom 26(9.2%) had detrusor areflexia, 7 patients (2.5%) had detrusor hyperreflexia, 26 patients (9.2%) had detrusor underactivity and 1 had detrusor/external sphincter dyssynergia. Among 30(10.6%) patients with bladder outlet obstruction, 6(2.1%) had primary bladder neck obstruction, 11(3.9%) urethral stricture, and 13(4.5%) functional detrusor/external sphincter dyssynergia. 68(24.0%) of patients had stress incontinence and 40(14.1%) were normal. Conclusion Urodynamic investigation could evaluate the detrusor function, as well as the precise anatomic location of bladder outlet obstruction. The urodynamic examination should be an essential examination for females with LUTS.