CAJ | 학술논문

目的比较常规尿动力学(CUD)和动态尿动力学检查(AUM)对女性压力性尿失禁(SUI)患者膀胱尿道功能异常检出率及尿动力学参数,探讨AUM在评估女性SUI中的应用价值.方法随机选取门诊女性SUI患者30例.年龄32 ～ 63岁,平均(49.4±9.4)岁.病程1～9年,平均(4.7±2.8)年.行尿失禁问卷表简表(ICI-Q-SF)问卷调查,根据ICI-Q-SF评分将患者分为轻、中、重3组,其中轻度尿失禁9例、中度15例、重度6例.行CUD检查和3个周期的AUM检查,分别记录并进行比较. 结果 30例患者AUM的SUI和逼尿肌过度活动(D0)检出率分别为90％和37％,明显高于CUD的70％和10％(P ＜0.05).对ICI-Q-SF评分为中、重度尿失禁且AUM与CUD同时检出SUI(伴或不伴急迫性尿失禁)的21例患者尿动力学参数进行比较发现,AUM组患者的腹压漏尿点压(ALPP)和排尿量显著低于CUD组(P＜0.05),逼尿肌压力显著高于CUD组(P＜0.05). 结论 AUM较CUD能更容易监测到患者SUI和DO的发生,SUI阳性率增高可能与AUM组患者ALPP值偏低有关.对于有临床症状而CUD检查未见明显异常的患者,可以进一步行AUM检查,降低SUI和DO的漏诊率.
목적 비교상규뇨동역학(CUD)화동태뇨동역학검사(AUM)대녀성압력성뇨실금(SUI)환자방광뇨도공능이상검출솔급뇨동역학삼수,탐토AUM재평고녀성SUI중적응용개치.방법 수궤선취문진녀성SUI환자30례.년령32 ～ 63세,평균(49.4±9.4)세.병정1～9년,평균(4.7±2.8)년.행뇨실금문권표간표(ICI-Q-SF)문권조사,근거ICI-Q-SF평분장환자분위경、중、중3조,기중경도뇨실금9례、중도15례、중도6례.행CUD검사화3개주기적AUM검사,분별기록병진행비교. 결과 30례환자AUM적SUI화핍뇨기과도활동(D0)검출솔분별위90％화37％,명현고우CUD적70％화10％(P ＜0.05).대ICI-Q-SF평분위중、중도뇨실금차AUM여CUD동시검출SUI(반혹불반급박성뇨실금)적21례환자뇨동역학삼수진행비교발현,AUM조환자적복압루뇨점압(ALPP)화배뇨량현저저우CUD조(P＜0.05),핍뇨기압력현저고우CUD조(P＜0.05). 결론 AUM교CUD능경용역감측도환자SUI화DO적발생,SUI양성솔증고가능여AUM조환자ALPP치편저유관.대우유림상증상이CUD검사미견명현이상적환자,가이진일보행AUM검사,강저SUI화DO적루진솔.
Objective To compare the application of ambulatory urodynamic(AUM)and conventional urodynamic(CUD)in detecting stress urinary incontinence(SUI)and detrusor overactivity(DO)in females.Methods Incontinence questionnaire short form(ICI-Q-SF),CUD and AUM were administrated on 30 female patients with the mean age of 49.4(32-63)years.The duration of symptom was 4.7 (1-9)years.The patients were divided into 3 groups of mild(n =9),moderate(n =15)and severe (n =6)according to ICI-Q-SF.Three micturition cycles were recorded during AUM.Results SUI and DO detected by AUM were 90％ and 37％,significantly more than those by CUD of 70％ and 10％(P ＜0.05).Twenty-one moderate and severe SUI patients diagnosed by ICI-Q-SF,detected by AUM and CUD simultaneously showed that abdominal leak point pressure(ALPP)and voided volume were lower,and detrusor pressure was higher recorded by AUM than those by CUD significantly(P ＜ 0.05).Conclusions SUI and DO are easier detected by AUM than by CUD.AUM is a useful additional tool in clinical practice for those patients CUD failed to explain their symptoms.