【作者】 马俊；

【导师】 陈忠；

【作者基本信息】 华中科技大学 ， 外科学（泌尿外科）， 2017， 硕士

【摘要】 【目的】对20例有OAB症状的患者,分别先后使用两种不完全相同的尿流动力学检查方法进行至少一个储尿和排尿周期的膀胱测压检查,这两种检查方式分别为:便携式尿动力（PUD）检查和常规式尿动力（CUD）检查,通过分析比较两种检查各自参数,来判断便携尿动力检测对OAB和BOO的诊断价值和优势,同时探讨便携式尿动力学检查的优缺点并改进,以获得最好的准确性【方法】按照选入及排除标准,在门诊随机选取符合标准的OAB患者共20例。在这20位患者中有12例是女性病人,8例男性病人,所有入选病人的年龄范围在19-46岁,平均为（31.6±8.3）岁,病程为1-6年,平均（3.8±2.3）年,按照标准方法对每位患者分别进行一个周期的CUD检查和一个周期的PUD检查,且为了减少误差,两种检查的先后顺序随机分配。然后分别记录各自的检查参数来判断膀胱功能,同时计算出两种不同方法检出的DO和BOO的例数。【结果】在这20例患者中,CUD诊断出DO的病人有16例,检出率80%,而PUD诊断发现DO的患者12例,检出率60%,CUD检查显著高于PUD检查（P<0.05）,PUD检查和CUD检查的最大逼尿肌收缩压力分别为（31.2±2.7）cmH₂O和（19.4±2.3）cmH₂O,PUD组显著高于CUD组（P<0.05）;PUD检查和CUD检查的最大尿流率分别为（21.6±3.5）ml/s和（18.2±5.4）ml/s,PUD显著大于CUD（P<0.05）。【结论】从本次研究来看,对OAB患者来说,CUD检查对比PUD检查有更高的DO诊断阳性率,其可能的原因为PUD检查过程更接近人体日常生活和自然生理及心理状态,而在CUD检查过程中,快速膀胱充盈可能会诱发逼尿肌不自主收缩产生假阳性结果,而PUD能减少这种假阳性的发生率,减低DO的误诊率。同时将两者检查时的最大逼尿肌收缩压力值进行比较,结果显示PUD检查对于OAB患者BOO的检出率要高于CUD检查。原因可能为患者在进行CUD检查时膀胱充盈速度过快,逼尿肌随之快速扩张而导致暂时性的收缩功能下降。更多还原

【Abstract】 【Objective】Twenty patients with OAB wypptoms were followed by two incomplete urinary electromagnetism tests,including at least one urinary cycle of the bladder pressure test,the two methods were:portable urodynamic（PUD）examination and routine urodynamic（CUD）examination,by comparing the two checks of their respective parameters,to determine the urine and urine detection of OAB and BOO diagnostic value and advantages.【Methods】In accordance with the selection and exclusion criteria,20 standard patients with OAB were randomly selected from the outpatient department.Among them,12 were female patients and 8 were male patients.The age of all patients was19-46 years（31.6±8.3）,with an average duration of 1-6 years（3.8±2.3）.according to the standard method for each patient were a cycle of CUD examination and a cycle of PUD examination,And in order to reduce the error,the order of the two checks were randomly assigned.And then recorded their respective inspection parameters to determine function,to calculate the detected DO and BOO cases.【Results】In these 20 patients,CUD diagnosed DO patients in 16 cases,the detection rate of 80%;And PUD found DO in 12 cases,the detection rate of60%.CUD examination was significantly higer than PUD examination（P<0.05）。The maximaldetrusorsystolicpressureofPUDandCUD were（31.2±2.7cmH₂O）and（19.4±2.3cmH₂O）。PUD was significantly higer than that in CUD group（P<0.05）。【Conclusions】From this study,for patients with OAB,CUD examination compared with PUD examination has a higer DO diagnosis positive rate.The possible reason for this is that the process of PUD examination inspection closer to the human daily life and natural physiological and psychological state.In the CUD examination,rapid bladder filing may induce detrusor involuntary contraction to produce false positive results,and PUD examination can reduce the incidence of this false positive reduce the misdiagnosis of DO.At the same time,the maximal detrusor systolic pressure at the time of the two examinations was compared.The results showed that the detection rate of BOO in PUD examination was higer than that in CUD examination.The Reason may be that the patient is in the CUD examination when the bladder filing speed too fast,detrusor with rapid expansion and lead to a temporary decline in systolic function.更多还原