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目的 探讨女性不同类型尿失禁临床及尿动力学特点,提高临床诊治水平。方法 对76例女性患者常规行尿动力学检查,包括尿流率、压力流率研究、尿道压力测定、漏尿点压测定。结果 76例患者中,压力性尿失禁30例,运动紧迫性尿失禁15例,反射性尿失禁19例,混合型压力性/紧迫性尿失禁2例,不稳定尿道3例,假性尿失禁7例。运动紧迫性尿失禁中,DLPP≥40cmH_2O者14例,均有不同程度双肾积水。结论 腹压漏尿点压测定可以协助确定压力性尿失禁的手术方式。神经性膀胱尿道功能障碍和膀胱出口梗阻均可能出现膀胱顺应性下降,逼尿肌漏尿点压可以帮助决定膀胱顺应性下降时手术治疗时机。当逼尿肌漏尿点压≥40 cmH_2O,或者膀胱充盈200 ml时逼尿肌压力≥40 cmH_2O时,必须进行治疗,否则会导致上尿路损害。
Objective To investigate the clinical and urodynamic characteristics of different types of incontinence in women and to improve the level of clinical diagnosis and treatment. Methods Totally 76 female patients underwent routine urodynamic tests, including the study of urinary flow rate, pressure flow rate, urethral pressure, and urinary leakage pressure. Results Among the 76 patients, 30 were stress urinary incontinence, 15 were urinary urge incontinence, 19 were incontinence incontinence, 2 were mixed stress / urge incontinence, 3 were unstable urethra, 7 cases. Urgency urinary incontinence, DLPP ≥ 40cmH_2O in 14 cases, both have varying degrees of hydronephrosis. Conclusions Abdominal pressure leakage pressure measurement can help determine the surgical approach to stress urinary incontinence. Neurogenic bladder and urethral dysfunction and bladder outlet obstruction may appear decreased bladder compliance, urinary bladder pressure can help determine the timing of surgical treatment of decreased bladder compliance. When detrusor leakage ≥ 40 cmH_2O, or detrusor pressure ≥ 40 cmH_2O when the bladder is filled with 200 ml, treatment must be performed as this may cause upper urinary tract damage.