国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
1期
20-23
,共4页
盆底脏器脱垂%下尿路功能%尿动力学
盆底髒器脫垂%下尿路功能%尿動力學
분저장기탈수%하뇨로공능%뇨동역학
Pelvic organ prolapse%Lower urinary tract function%Urodynamics
目的 探讨盆底脏器脱垂患者与下尿路功能障碍之间的关系.方法 于2009年7月-2010年11月对54例诊断为盆腔脏器脱垂的住院患者进行病史采集、妇科检查、POP-Q评分及尿动力学检查,探讨盆腔脏器脱垂与下尿路功能障碍的关系.结果 54例POP患者中,出现下尿路主观症状44例,其中尿失禁症状27例(压力性24例,急迫性1例,混合性2例),尿急和/或尿频27例,排尿功能障碍16例.尿动力学检查结果显示:压力性尿失禁28例,急迫性尿失禁2例,混合性尿失禁2例,伴膀胱顺应性降低1例,腹压排尿3例.腹部漏尿点压力( ALPP)＜ 60 cmH2O有10例,60 ～ 90 cmH2O 13例,＞90 cmH2O 7例.与尿失禁主观症状的符合率为70％( 19/27)；隐匿性尿失禁的发生率为41％( 11/27),均为重度阴道前壁脱垂的患者.结论 POP患者术前在减轻脱垂程度情况下行尿动力学检查可更客观地评价下尿路功能障碍,POP患者术前应了解膀胱及尿道括约肌功能,注意排除隐匿性尿失禁.
目的 探討盆底髒器脫垂患者與下尿路功能障礙之間的關繫.方法 于2009年7月-2010年11月對54例診斷為盆腔髒器脫垂的住院患者進行病史採集、婦科檢查、POP-Q評分及尿動力學檢查,探討盆腔髒器脫垂與下尿路功能障礙的關繫.結果 54例POP患者中,齣現下尿路主觀癥狀44例,其中尿失禁癥狀27例(壓力性24例,急迫性1例,混閤性2例),尿急和/或尿頻27例,排尿功能障礙16例.尿動力學檢查結果顯示:壓力性尿失禁28例,急迫性尿失禁2例,混閤性尿失禁2例,伴膀胱順應性降低1例,腹壓排尿3例.腹部漏尿點壓力( ALPP)＜ 60 cmH2O有10例,60 ～ 90 cmH2O 13例,＞90 cmH2O 7例.與尿失禁主觀癥狀的符閤率為70％( 19/27)；隱匿性尿失禁的髮生率為41％( 11/27),均為重度陰道前壁脫垂的患者.結論 POP患者術前在減輕脫垂程度情況下行尿動力學檢查可更客觀地評價下尿路功能障礙,POP患者術前應瞭解膀胱及尿道括約肌功能,註意排除隱匿性尿失禁.
목적 탐토분저장기탈수환자여하뇨로공능장애지간적관계.방법 우2009년7월-2010년11월대54례진단위분강장기탈수적주원환자진행병사채집、부과검사、POP-Q평분급뇨동역학검사,탐토분강장기탈수여하뇨로공능장애적관계.결과 54례POP환자중,출현하뇨로주관증상44례,기중뇨실금증상27례(압력성24례,급박성1례,혼합성2례),뇨급화/혹뇨빈27례,배뇨공능장애16례.뇨동역학검사결과현시:압력성뇨실금28례,급박성뇨실금2례,혼합성뇨실금2례,반방광순응성강저1례,복압배뇨3례.복부루뇨점압력( ALPP)＜ 60 cmH2O유10례,60 ～ 90 cmH2O 13례,＞90 cmH2O 7례.여뇨실금주관증상적부합솔위70％( 19/27)；은닉성뇨실금적발생솔위41％( 11/27),균위중도음도전벽탈수적환자.결론 POP환자술전재감경탈수정도정황하행뇨동역학검사가경객관지평개하뇨로공능장애,POP환자술전응료해방광급뇨도괄약기공능,주의배제은닉성뇨실금.
Objective To explore the relationship between pelvic organ prolapse and lower urinary tract dysfunction.Methods From July,2009 to November,2010,collected the medical history of 54 patients diagnosed with pelvic organ prolapse,and conducted gynecological examination and pelvic organ prolapse quantitative examination ( POP-Q )on them,then explored the relationship between pelvic organ prolapse and lower urinary tract dysfunction.Results Among all the patients with POP,44 cases developed subjective symptoms of lower urinary tract,among which,27 cases had urinary incontinence ( 24 with stress,1 with urgency,2 with mixed incontinence ); 27 cases got bladder irritation; 16 cases underwent with voiding dysfunction.The urodynamic tests revealed that:28 cases had stress urinary incontinence,2 cases had urgent incontinence,2 cases got mixed incontinence,1 case had reduced bladder compliance,and 3 cases had abdominal voiding.There were 10 cases with abdominal leak point pressure ( ALPP ) ＜ 60 cmH2O,7 cases between 60-90 cmH2O,13 cases ＞ 90 cmH2O.70％( 19/27 ) of the patients with symptoms of stress incontinence were confirmed genuine incontinence by urodynamics test; the incidence of occult incontinence was 41％ ( 11/27 ),all of which were diagnosed with severe anterior vaginal wall prolapse.Conclusions Prior to the operation, testing the urodynamics of POP patients under the condition of relieving the severity of pelvic organ prolapse can more objectively assess urinary tract dysfunction.Patients with POP before surgery should be informed the bladder and urethral sphincter function,and should pay attention on occult incontinence.
