Wu Guoxing,Wu Ruifa,Li Honghui,et al.Application of free video uroflowmetry in the evaluation of lower urinary tract dysfunction in children[J].Journal of Clinical Pediatric Surgery,2026,(07):637-641.[doi:10.3760/cma.j.cn101785-20260330-00144]
自由影像尿流测定在儿童下尿路功能障碍评估中的应用
- Title:
- Application of free video uroflowmetry in the evaluation of lower urinary tract dysfunction in children
- 摘要:
- 目的 探讨自由影像尿流测定评估下尿路功能障碍的可行性及临床价值。方法 回顾性分析东莞市儿童医院2025年1月至2025年7月期间因下尿路功能障碍住院患儿的自由影像尿流率测定资料。患儿住院期间均完善自由尿流率检查(free uroflow,FF)、影像尿动力学检查(video urodynamics study,VUDS)及自由影像尿流测定检查(free video uroflowmetry,FVU),并以此分成3组:自由尿流率检查组(FF组)、影像尿动力学检查组(VUDS组)及自由影像尿流测定检查组(FVU组)。比较三组的尿流测定参数(最大尿流率、平均尿流率、排尿时间、排尿量、膀胱残余尿量)和影像学阳性事件(是否存在膀胱输尿管反流、逼尿肌括约肌协同失调、假性残余尿增多)。结果 共51例纳入本研究,其中男28例、女23例,年龄(7.49±2.09)岁。FF组与FVU组最大尿流率、平均尿流率、排尿时间、排尿量、膀胱残余尿量比较,差异无统计学意义(P>0.05),FF组和VUDS组最大尿流率[(17.02±7.13)mL/s比(10.55±7.10mL/s)]、平均尿流率[(9.45±4.39)mL/s比(4.34±2.93)mL/s]、排尿时间[16.50(13.00,27.00)s比41.00(27.00,68.00)s]、膀胱残余尿量[0.00(0.00,20.00)mL比21.00(10.00,70.00)mL]比较,差异有统计学意义(P<0.05)。FVU组和VUDS组最大尿流率[(15.95±6.26)mL/s比(10.55±7.10)mL/s],平均尿流率[(7.90±3.73)mL/s比(4.34±2.93)mL/s],排尿时间[21.80(15.90,31.00)s比41.00(27.00,68.00)s)],膀胱残余尿量[0.00(0.00,22.00)mL比21.00(10.00,70.00)mL]比较,差异有统计学意义(P<0.05);而FF组、FVU组分别与VUDS组在排尿量上比较,差异无统计学意义(P＞0.05)。FVU组在膀胱输尿管反流、逼尿肌括约肌协同失调、假性残余尿增多的影像学阳性事件检出率与VUDS组比较,差异无统计学意义(P＞0.05)。结论 自由影像尿流测定能在更接近自然排尿状态下评估排尿功能,同时能够清晰显示膀胱尿道形态结构和判断是否存在膀胱输尿管反流、逼尿肌-尿道括约肌协同失调以及假性残余尿量增多的情况,为缺乏压力-流率测定、影像尿动力学设备的医疗机构(尤其基层医院)提供一种可同时获取膀胱尿道功能及形态的有效方法。
- Abstract:
- Objective To investigate the feasibility and clinical value of free video uroflowmetry in evaluating lower urinary tract dysfunction (LUTD). Methods The data of free video uroflowmetry in children hospitalized for LUTD at Dongguan Children’s Hospital from January 2025 to July 2025 were retrospectively analyzed.During hospitalization,all children underwent free uroflowmetry (FF),video urodynamics (VUDS),and free video uroflowmetry (FVU).Accordingly,the examinations were divided into three groups:the free uroflowmetry group (FF group),the video urodynamics study group (VUDS group),and the free video uroflowmetry group (FVU group).Uroflowmetric parameters,including maximum flow rate,average flow rate,voiding time,voided volume,and postvoid residual urine volume,as well as positive imaging events,including the presence of vesicoureteral reflux,detrusor-sphincter dyssynergia,and pseudo-increased residual urine,were compared among the three groups.Results A total of 51 children were included in this study,including 28 boys and 23 girls,with a mean age of (7.49±2.09) years.There were no statistically significant differences between the FF and FVU groups in maximum flow rate,average flow rate,voiding time,voided volume,or postvoid residual urine volume (P>0.05).There were statistically significant differences between the FF and VUDS groups in maximum flow rate[(17.02±7.13) mL/s vs.(10.55±7.10) mL/s],average flow rate[(9.45±4.39) mL/s vs.(4.34±2.93) mL/s],voiding time[16.50 (13.00,27.00) s vs.41.00 (27.00,68.00) s],and postvoid residual urine volume[0.00 (0.00,20.00) mL vs.21.00 (10.00,70.00) mL](P<0.05).There were also statistically significant differences between the FVU and VUDS groups in maximum flow rate[(15.95±6.26) mL/s vs.(10.55±7.10) mL/s],average flow rate[(7.90±3.73) mL/s vs.(4.34±2.93) mL/s],voiding time[21.80 (15.90,31.00) s vs.41.00 (27.00,68.00) s],and postvoid residual urine volume[0.00 (0.00,22.00) mL vs.21.00 (10.00,70.00) mL](P<0.05).However,there were no statistically significant differences in voided volume between the FF and VUDS groups or between the FVU and VUDS groups (P>0.05).The detection rates of positive imaging events,including vesicoureteral reflux,detrusor-sphincter dyssynergia,and pseudo-increased residual urine,did not differ significantly between the FVU and VUDS groups (P>0.05).Conclusion Free video uroflowmetry can evaluate voiding function under conditions closer to natural voiding,while clearly displaying the morphological structure of the bladder and urethra and determining the presence of vesicoureteral reflux,detrusor-urethral sphincter dyssynergia,and pseudo-increased residual urine volume.It provides an effective method for medical institutions lacking pressure-flow studies or video urodynamic equipment,especially primary hospitals,to simultaneously obtain functional and morphological information of the bladder and urethra.
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备注/Memo
收稿日期:2026-3-30。
基金项目:国家自然科学基金项目(82470807、U1904208)
通讯作者:文建国,Email:jgwen@zzu.edu.cn