摘要
目的 探讨中老年男性逼尿肌活动低下(DU)及合并膀胱出口梗阻(BOO)的尿动力学特点.方法 对郑州大学第一附属医院尿动力学中心2020年11月至2023年6月尿动力学资料完整的50岁以上男性患者317例进行回顾性分析,通过压力流率Schaefer列线图将患者分为DU组、BOO组、DU+BOO组和对照组.对组间尿动力学参数进行比较.结果 DU组67例,BOO组144例,DU+BOO组70例,对照组36例,4组患者年龄差异无统计学意义(P＞0.05).DU组较对照组初始排尿感容量、残余尿量和最大尿流率时腹压增高(P＜0.05),而最大尿流率、最大尿流率时逼尿肌压力、膀胱排空率和逼尿肌收缩力因子降低(P＜0.05);DU组较BOO组初始排尿感容量、最大膀胱测压容量和最大尿流率时腹压增高(P＜0.05),而最大尿流率时逼尿肌压力、逼尿肌过度活动比率、膀胱出口梗阻因子(BOOI)和逼尿肌收缩力因子降低(P＜0.05);DU组较DU+BOO组初始排尿感容量、最大尿流率和最大尿流率时腹压增高(P＜0.05),而最大尿流率时逼尿肌压力、逼尿肌过度活动比率、BOOI和逼尿肌收缩力因子降低(P＜0.05).结论 中老年DU男性主要尿动力学特点为充盈期膀胱感觉降低,逼尿肌过度活动比率低和排尿时腹压增高,合并BOO者则残余尿量增多,BOOI和逼尿肌收缩力因子高,而最大尿流率和膀胱排空率低,应及时给予治疗.
Abstract
Objective To analysis the urodynamic characteristics in middle-aged and elderly men with detrusor underactivity(DU)and DU combined with bladder outlet obstruction(BOO).Methods A retrospective analysis was performed on 317 male patients over 50 years of age with complete urodynamic data from the Urodynamic Center of the First Affiliated Hospital of Zhengzhou University from November 2020 to June 2023.The patients were divided into DU group,BOO group,DU+BOO group and control group according to the pressure flow rate Schaefer diagram.The parameters of urodynamics among the four groups were compared.Results There were 67 patients in DU group,144 cases in BOO group,70 cases in DU+BOO group and 36 cases in control group.There was no statistical difference in age among the four groups(P＞0.05).Compared with control group,the first desire volume,post-voided residual and abdominal pressure at maximum urine flow rate were significantly increased(P＜0.05),while maximum urine flow rate,detrusor pressure at maximum urine flow rate,voiding efficiency and bladder contractility index were significantly decreased in DU group(P＜0.05).Compared with BOO group,the the first desire volume,maximum cytometric capacity and abdominal pressure at maximum urine flow rate were significantly increased(P＜0.05),while detrusor pressure at maximum urine flow rate,detrusor overactivity incidence,bladder outlet obstruction index(BOOI)and bladder contractility index were significantly decreased in DU group(P＜0.05).Compared with DU+BOO group,the first desire volume,maximum urine flow rate,abdominal pressure at maximum urine flow rate were significantly increased(P＜0.05),while detrusor pressure at maximum urine flow rate,detrusor overactivity incidence,BOOI and bladder contractility index were significantly decreased in DU group(P＜0.05).Conclusion The main urodynamic characteristics in middle-aged and elderly men with DU were reduced bladder sensation during filling period,low detrusor overactivity rate and increased abdominal pressure during urination.In DU patients combined with BOO,post-voided residual increased,BOOI and bladder contractility index were high,and maximum urine flow rate and voiding efficiency were low.Prompt treatment should be given.
基金项目
河南省医学科技攻关计划省部共建项目(SBGJ2018059)
国家自然科学基金联合基金(U1904208)
NETL
NSTL
万方数据