急性尿潴留患者的尿动力学研究

目的 探讨急性尿潴留产生的原因及其膀胱逼尿肌功能的改变.方法 结合尿动力学检查结果回顾性分析178例急性尿潴留患者的临床资料.结果 在男性患者中,年龄50岁者急性尿潴留原因主要为前列腺增生导致膀胱出口梗阻,占60.63%(77/127);年龄≤50岁者急性尿潴留原因主要为腰骶段脊椎外伤后逼尿肌收缩功能低下,占72.55%(37/51).各年龄段女性患者急性尿潴留原因皆为逼尿肌收缩功能低下;年龄50岁男性患者与同年龄段女性患者膀胱低顺应性及逼尿肌收缩功能低下比较差异有统计学意义(P<0.01),不稳定膀胱及膀胱出口梗阻比较差异亦有统计学意义(P<0.05).结论 老年男性患者产生急性尿潴留的原因主要为膀胱出口梗阻;而女性及中青年男性患者急性尿潴留的原因主要以逼尿肌收缩功能低下为主,其逼尿肌收缩功能依不同的病因出现不同的改变.

Urodynamic study on acute urinary retention cases

Objective To explore the cause of acute urinary retention (AUR) ,the functional change of bladder detrusor. Methods The clinical data in 178 patients with AUR combined with urodynamic study were retrospectively analyzed. Results In male patients,the main cause of AUR was bladder oudet obstruction(BOO) ,the percent was 60.63%(77/127) ,in age more than 50 years old patients, while, in age less than 50 years old patients,the main cause was detrusor arcflexia (DUA), the percent was 72.55% (37/51), because of trauma of Iumbosacral vertebrae. In the female patients, the main cause of AUR was DUA. Between male and female patients with age more than 50 years old, there was significant difference in the cases of low compliance and DUA (P < 0.01) ,unstable bladder and BOO (P < 0.05). Conclusions The main cause of AUR in elderly male patients is BOO, which induces low eompliance and unstable bladder. While the main cause of AUR in female patients and young-middle age male is DUA .The function of detrusor changes differently with various causes.