CAJ | 학술논문

目的探讨女性膀胱出口梗阻(BOO)患者影像尿动力学检查特点及意义.方法女性BOO患者42例,根据梗阻部位分为膀胱颈梗阻(7例)、中段尿道梗阻(13例)、远端尿道梗阻(15例)、尿道外口梗阻(3例)、盆腔器官重度脱垂(4例)5组.患者术前均行影像尿动力学检查,比较5组病例Qmax、最大膀胱容量、Pdet atQmax、残余尿、逼尿肌无抑制收缩、双侧肾积水等指标.结果 42例患者中以尿频、尿急等储尿症状为主者17例(40.5%),以排尿困难等为主者4例(9.5%),混合症状者21例(50.0%).42例Qmax(10.9±5.6)ml/s、最大膀胱容量(253±140.7)ml、Pdet atQmax(53.3±25.7)cm H2O、残余尿量(76.2±70.3)ml,逼尿肌无抑制收缩者21例(50.0%);5组患者比较:最大膀胱容量差异无统计学意义;膀胱颈梗阻组Pdet atQmax最高、残余尿量最多、Qmax最低、肾积水比例最高,与其他各组比较差异有统计学意义(P<0.05);逼尿肌无抑制收缩在外括约肌部梗阻患者中10例(76.9%),与其他各组比较差异有统计学意义(P<0.05).结论影像尿动力学检查能有效评估女性BOO下尿路功能,提示梗阻部位并指导临床治疗.女性BOO患者中膀胱颈梗阻程度是影响上尿路损害的主要因素.
목적 탐토녀성방광출구경조(BOO)환자영상뇨동역학검사특점급의의.방법 녀성BOO환자42례,근거경조부위분위방광경경조(7례)、중단뇨도경조(13례)、원단뇨도경조(15례)、뇨도외구경조(3례)、분강기관중도탈수(4례)5조.환자술전균행영상뇨동역학검사,비교5조병례Qmax、최대방광용량、Pdet atQmax、잔여뇨、핍뇨기무억제수축、쌍측신적수등지표.결과 42례환자중이뇨빈、뇨급등저뇨증상위주자17례(40.5%),이배뇨곤난등위주자4례(9.5%),혼합증상자21례(50.0%).42례Qmax(10.9±5.6)ml/s、최대방광용량(253±140.7)ml、Pdet atQmax(53.3±25.7)cm H2O、잔여뇨량(76.2±70.3)ml,핍뇨기무억제수축자21례(50.0%);5조환자비교:최대방광용량차이무통계학의의;방광경경조조Pdet atQmax최고、잔여뇨량최다、Qmax최저、신적수비례최고,여기타각조비교차이유통계학의의(P<0.05);핍뇨기무억제수축재외괄약기부경조환자중10례(76.9%),여기타각조비교차이유통계학의의(P<0.05).결론 영상뇨동역학검사능유효평고녀성BOO하뇨로공능,제시경조부위병지도림상치료.녀성BOO환자중방광경경조정도시영향상뇨로손해적주요인소.
Objective To analyze videourodynamic characteristics of female bladder outlet obstruction (BOO). Methods Retrospective analysis of videourodynamic characteristics were performed in 42 women with BOO. On the basis of the videourodynamic findings, women with BOO were categorized into five groups: bladder neck obstruction, middle urethra (urethral sphincter) obstruction, distal urethra obstruction, external orifice of urethra obstruction, high-grade pelvic organ prolapse. Data of five groups were compared in Qmax, maximum cystometric capacity, Pdet at Qmax, residual urine, detrusor instability and hydronephrosis. Data of all patients were analyzed by SPSS13 statistical software, measurement data by t-test and enumeration data by x2-test. Results Five groups had not significant deviation in the maximum cystometric capacity. however patients with bladder neck obstruction had significant deviation with others in Pdet at Qmax (78. 0 ± 23. 6)cm H2O, residual urine (120. 6±115.2)ml, Qmax (7.0±2.3)ml/s (P<0.05). There was significant deviation between middle urethra (urethral sphincter) obstruction(76.9%)and others in detrusor instability(P<0. 05). In all patients with hydronephrosis, bladder neck obstruction(57. 1 %) had significant deviation with others (P<0. 05). Conclusions Videourodynamic tests could assess lower urinary tract function, and may guide clinic management. The bladder neck obstruction was most serious and harmful to upper urinary tract.