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目的 研究女性原发性膀胱颈梗阻 (PBNO)的临床及尿动力学特点。方法 回顾性分析 6 1例原发性膀胱颈梗阻及 32例压力性尿失禁病例尿动力学检查结果。结果 PBNO病人分为内括约肌痉挛症 (ISS)组及非交感神经功能亢进 (NSO)组 ,前者 41例改良苄胺唑啉尿道压力分布(UPP)试验阳性而后者 2 0例内窥镜检见膀胱颈抬高现象。压力 /流率测定成功率ISS组低于NSO组及对照组 (49%、80 %、81% )。ISS组及NSO组直线被动尿道阻力关系 (Lin PURR)BOO分级94 4%在Ⅱ级以上 ,而对照组 99 3%在 0 Ⅰ级。ISS组及NSO组较对照组有显著差异的指标为膀胱开放逼尿肌压 (Pvb)、A G数 (PdetQmax 2Qmax)、剩余尿量及最大尿道闭合压 (MUCP)。结论 PB NO诊断重要参数为Lin PURR分级、Pvb及A G数 ,改良苄胺唑啉UPP试验是内括约肌功能性梗阻定性定位良好指标。Lin PURRⅡ级以上提示有梗阻。
Objective To study the clinical and urodynamic characteristics of female primary bladder neck obstruction (PBNO). Methods The urodynamic results of 61 cases of primary bladder neck obstruction and 32 cases of stress urinary incontinence were analyzed retrospectively. Results The patients with PBNO were divided into the group of internal sphincter spasm (ISS) and the group of non-sympathetic hyperactivity (NSO). In the former group, 41 cases were positive for modified urethral pressure distribution (UPP) test while the latter 20 cases were endoscopic Bladder neck elevation phenomenon. Pressure / flow rate was lower in the ISS group than in the NSO group and in the control group (49%, 80%, 81%). The linear passive urethral resistance (Lin PURR) in ISS group and NSO group was 94 4% higher than grade Ⅱ, while 99 3% in control group was 0 Ⅰ grade. ISS group and NSO group compared with the control group were significant indicators of bladder open detrusor pressure (Pvb), A G number (PdetQmax 2Qmax), residual urine volume and maximum urethral closure pressure (MUCP). Conclusions The important parameters of PB NO diagnosis are Lin PURR grade, Pvb and A G number. The improved benzylazoline UPP test is a good indicator of the qualitative localization of functional obstruction of internal sphincter. Lin PURR level above tips have obstruction.