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目的 探讨同步膀胱膜部尿道压力测定的临床意义。 方法 采用DantecDuet尿动力学仪同步测定 412例泌尿系病人和 6例健康者充盈和排尿时的膀胱和膜部尿道压力 ,肌电图用直肠电极测定。 结果 (1)健康人充盈期膜部尿道压 ,男性为 40～ 5 0cmH2 O ,女性为 2 0～ 30cmH2 O ,充盈期膜部尿道压高于膀胱压 ,且全充盈期没有明显变化 ,排尿时膜部尿道压力明显下降低于膀胱压。 (2 )逼尿肌尿道协同失调的病人 ,排尿时膜部尿道压升高 ,其中逼尿肌外括约肌协同失调 (DEDS)时合并有肌电活动明显增加 ,逼尿肌膀胱颈协同失调 (DBDS)肌电活动正常 ,排尿期尿道测压膀胱颈处压力呈斜坡样下降。 (3)尿道关闭机制下降或不全时充盈期膜部尿道压明显低 ,且充盈期膜部尿道膀胱压力差为负值。 (4 )尿道不稳定时充盈期膜部尿道压突然下降且幅度≥ 15cmH2 O。 (5 )正常尿道腹压传递率为 2 0 %～ 35 % ,而压力性尿失禁 (GUI)病人尿道腹压传递率 <2 0 %。 结论 同步膀胱膜部尿道压力测定操作简单 ,在判断尿道关闭机制的正常与否、逼尿肌尿道的协同与否、尿道稳定性及腹压向尿道的传递效率方面有重要价值。
Objective To investigate the clinical significance of urethral pressure measurement in synchronous bladder membrane. Methods The bladder and diaphragm urethral pressures of 412 urinary system patients and 6 healthy subjects during filling and urination were determined synchronously by Dantec Duet urodynamic analyzer. The electromyography was measured by rectal electrode. Results (1) Urethral pressure in healthy infants was 40 ~ 50 cm H 2 O and 20 ~ 30 cm H 2 O in healthy infants. The urethral pressure at filling stage was higher than that of bladder pressure, and there was no significant change during full filling. Department of urethra pressure decreased significantly lower than the bladder pressure. (2) In patients with detrusor and urethral dyskinesia, urethral pressure was high at the time of micturition, in which detrusor external sphincter dysfunction (DEDS) with combined myoelectrical activity increased significantly, detrusor bladder neck synergy (DBDS ) Normal myoelectrical activity, urinary bladder pressure at the urinary bladder neck pressure was ramp-like decline. (3) urethral closure mechanism decreased or incomplete Filling period urethral pressure was significantly lower, and during filling period urethral bladder pressure difference is negative. (4) Department of urethral instability filling membrane urethral pressure suddenly decreased and amplitude ≥ 15cmH2O. (5) The transfer rate of normal urethral pressure was 20% -35%, while urethral pressure transmission rate was less than 20% in stress urinary incontinence (GUI) patients. Conclusions Simultaneous determination of urethral pressure in the cysta partis is simple and has important value in judging whether the urethral closure mechanism is normal or not, synergy of detrusor and urethra, urethral stability and the transfer of abdominal pressure to the urethra.