CAJ | 학술논문

目的探讨女性盆底器官脱垂伴尿失禁患者膀胱储尿期和排尿期的尿动力学参数变化. 方法对182例女性尿失禁和盆底器官脱垂患者进行尿动力学检查,其中尿失禁140例,尿失禁伴盆底器官脱垂42例.在统一标准下行尿动力学检查测定膀胱灌注量、排尿量、膀胱顺应性、最大尿流率、最大尿流率逼尿肌压、最小尿流率逼尿肌压、尿道阻力因子(URA)、膀胱梗阻指数(OBI)以及归-化逼尿肌收缩力,评价女性尿失禁患者盆底器官脱垂对膀胱储尿功能和排尿功能的影响. 结果尿失禁组与尿失禁伴盆底器官脱垂组患者尿失禁病程[(58.1±75.4)与(41.9±55.4)个月]、膀胱灌注量[(295.3±95.8)与(276.5±80.8)ml]、膀胱顺应性[(77.7±122.1)与(51.5±61.9)ml/cm H2O]、最大尿流率[(15.8±12.5)与(14.7±13.9)ml/s]、最小尿流率逼尿肌压[(3.2±5.8)与(2.8±5.5)ml/cm H2O]、归-化逼尿肌收缩力[(7.5±12.8)与(8.2±13.8)cm H2O]相比差异均无统计学意义(P>0.05);而年龄[(58.7±12.2)与(67.1±8.3)岁]、排尿量[(269.2±145.2)与(248.9±135.1)ml]、最大尿流率逼尿肌压[(20.4±16.2)与(25.7±21.3)cm H2O]、URA[(11.3±9.5与(14.8±12.6)cm H2O]、OBI[(15.6±14.5)与(21.7±20.1)cm H2O]2组相比差异有统计学意义(P<0.05).结论高龄女性尿失禁患者更可能伴有盆底器官脱垂,而盆底器官脱垂对膀胱储尿功能无影响,但可影响排尿期相关参数,增加膀胱出口阻力和膀胱残余尿量.
목적 탐토녀성분저기관탈수반뇨실금환자방광저뇨기화배뇨기적뇨동역학삼수변화. 방법대182례녀성뇨실금화분저기관탈수환자진행뇨동역학검사,기중뇨실금140례,뇨실금반분저기관탈수42례.재통일표준하행뇨동역학검사측정방광관주량、배뇨량、방광순응성、최대뇨류솔、최대뇨류솔핍뇨기압、최소뇨류솔핍뇨기압、뇨도조력인자(URA)、방광경조지수(OBI)이급귀-화핍뇨기수축력,평개녀성뇨실금환자분저기관탈수대방광저뇨공능화배뇨공능적영향. 결과 뇨실금조여뇨실금반분저기관탈수조환자뇨실금병정[(58.1±75.4)여(41.9±55.4)개월]、방광관주량[(295.3±95.8)여(276.5±80.8)ml]、방광순응성[(77.7±122.1)여(51.5±61.9)ml/cm H2O]、최대뇨류솔[(15.8±12.5)여(14.7±13.9)ml/s]、최소뇨류솔핍뇨기압[(3.2±5.8)여(2.8±5.5)ml/cm H2O]、귀-화핍뇨기수축력[(7.5±12.8)여(8.2±13.8)cm H2O]상비차이균무통계학의의(P>0.05);이년령[(58.7±12.2)여(67.1±8.3)세]、배뇨량[(269.2±145.2)여(248.9±135.1)ml]、최대뇨류솔핍뇨기압[(20.4±16.2)여(25.7±21.3)cm H2O]、URA[(11.3±9.5여(14.8±12.6)cm H2O]、OBI[(15.6±14.5)여(21.7±20.1)cm H2O]2조상비차이유통계학의의(P<0.05).결론고령녀성뇨실금환자경가능반유분저기관탈수,이분저기관탈수대방광저뇨공능무영향,단가영향배뇨기상관삼수,증가방광출구조력화방광잔여뇨량.
Objective To compare the urodynamic parameters in female patients with incontinence with or without pelvic organ prolapse. Methods The urodynamic data from 140 patients diagnosed urinary incontinence and another 42 patients coexisted with pelvic organ prolapse were reviewed and analyzed. The urodynamics parameters were compared in perfusion, urination, bladder compliance, maximum urinary flow rate (Qmax), detrusor muscle pressure of maximum urinary flow rate (Pdet,Qmax), minimum urinary flow rate(Pdet, Qmax), urethral resistance factor (RUA), obstruction of bladder index (OBI) and normalized detrusor contractility. The influence of pelvic organ prolapses with incontinence on bladder filling and voiding function was evaluated also.Results There were no significant differences between 140 patients of urinary incontinence and 42 patients coexisted with pelvic organ prolapse in perfusion (P=0.142), bladder compliance (P=0.273), Qmax(P=0.192),Pdet (P=-0. 629), Qmin (P=0.365) and normalized detrusor contractility (P=0.380). There were significant differences in age(P=2.2×10-5), urination(P=0.034), Pdet.Qmax(P=0.045), RUA(P=0.018), OBI (P=0.017). Conclusions There is not clinically significant change in urine storage function of bladder in patients with pelvic organ prolapse, but the parameters of voiding function of bladder may existe difference. The increased bladder outlet resistance and postvoid residual urine are noticed in patients with pelvic organ prolapse.