神经源性膀胱括约肌功能障碍患儿下尿路尿动力学表现的研究
罗 娟,徐加龙,刘 倩,孙小刚,马 楠,王春田,李金良

山东大学第二医院小儿外科(山东省济南市,250033)

膀胱, 神经源性; 膀胱疾病; 尿动力学; 研究

Urodynamic performance of lower urinary tract in children of neuropathic bladder-sphincter dysfunction.
Luo Juan,Xu Jialong,Liu Qian,Sun Xiaogang,Ma Nan,Wang Chuntian,Li Jinliang.

Department of Pediatric Surgery,Second Hospital,Shandong University,Jinan 250033,China.

Urinary Bladder, Neurogenic; Urinary Bladder Diseases; Urodynamics; Research

DOI: 10.3969/j.issn.1671— 6353.2018.07.007

备注

目的 描述并分析神经源性膀胱括约肌功能障碍患儿的下尿路尿动力学表现。方法 回顾性分析神经源性膀胱括约肌功能障碍(neuropathic bladder-sphincterdysfunction,NBSD)及原发性遗尿症患儿(primary nocturnal enuresis,PNE)的尿动力学检查结果,比较两种疾病患儿逼尿肌不自主收缩、充盈期逼尿肌压、尿道功能长度(functional urethral length,FUL)及最大尿道闭合压(maximum urethral closure pressure,MUCP)四项指标的差异。应用SPSS13.0统计软件进行分析。结果 NBSD和PNE各纳入200例,分别为NBSD组和PNE组。NBSD组患儿中,逼尿肌反射亢进占69.0%,MUCP降低占91.0%,充盈期逼尿肌压升高占65.5%; PNE组中,逼尿肌不稳定、充盈期逼尿肌压升高者分别占45.0%、43.5%,MUCP降低者占37.5%,两组间各项异常率的差异均具有统计学意义(P<0.05)。NBSD组患儿充盈期逼尿肌压、FUL及MUCP的均值依次为(35.52±4.38)cmH2O、(1.73±0.13)cm、(42.84±4.54)cmH2O; PNE组患儿充盈期逼尿肌压、FUL及MUCP的均值依次为(17.32±2.42)cmH2O、(3.16±0.17)cm、(83.10±6.99)cmH2O; 两组间各指标差异均具有统计学意义(P<0.05)。结论 与遗尿症患儿相比,神经源性膀胱括约肌功能障碍患儿下尿路尿动力学表现异常率偏高,这为临床诊治该类疾病提供了一定的指导与方向。
Objective To explore the urodynamic performance of lower urinary tract in children of neuropathic bladder-sphincter dysfunction(NBSD). Methods The urodynamic outcomes of NBSD and primary nocturnal Enuresis(PNE)were retrospective analyzed.And detrusor hyperreflexia,pressure of detrusor in filling period,functional urethral length(FUL)and maximum urethral closure pressure(MUCP)were examined.All data were analyzed by SPSS 13.0 for statistical analysis. Results In NBSD group,the ratio of detrusor hyperreflexia was 69.0%; the ratio of pressure of detrusor rising in filling period 65.5%; And the ratio of MUCP decreasing 91.0%.In PNE group,the ratio of detrusor instabillty was 45.0%; the ratio of pressure of detrusor rising 43.5%; and the ratio of MUCP decreasing 37.5%.Significant inter-group differences existed(P<0.05).In NBSD group,the pressure of detrusor in filling period was 35.52±4.38 cmH2O; MUCP 42.84±4.54 cmH2O and FUL 1.73±0.13 cm.In PNE group,the pressure of detrusor in filling period was 17.32±2.42 cmH2O; MUCP 83.10±6.99 cmH2O; And FUL was 3.16±0.17cm.There were significant inter-group differences(P<0.05). Conclusion There is a high abnormal rate in urodynamic outcomes between children of NBSD versus PNE.Thus it provides valuable rationales for clinical diagnosis and treatment.