女性复杂性下尿路感染患者影像尿动力学检查的临床意义
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摘要
目的探讨女性复杂性下尿路感染患者影像尿动力学(VUD)检查的临床意义。方法对103例女性复杂性下尿路感染患者进行VUD检查(包括自由尿流率测定、膀胱充盈期、排尿期功能测定、同步影像显示等),并分析检查结果,以明确引起复杂性下尿路感染的病因。结果根据VUD分析结果,103例女性复杂性下尿路感染患者患者的病因主要有3类:(1)膀胱出口梗阻78例,其中合并逼尿肌过度活动39例,逼尿肌-括约肌协同失调4例(排尿期逼尿肌收缩良好3例,逼尿肌无反射1例);(2)膀胱脱垂15例(包括中央型11例、外侧型4例),合并逼尿肌过度活动3例;(3)尿道憩室10例,伴憩室结石1例。结论 VUD检查有助于明确女性复杂性下尿路感染的病因,为临床治疗提供依据。
Objective To evaluate the application of video urodynamics(VUD) in female patients with complicated urinary tract infections. Methods One hundred and three female patients with complicated lower urinary tract infections underwent VUD examination,the free urinary flow rate, bladder filling period, urination function measurement and synchronous imaging display were documented. The results were analyzed to identify the etiology of complex lower urinary tract infections. Results The VUD examination revealed that there were 78 cases of bladder outlet obstruction. Thirty-nine cases complicated with detrusor overactivity and 4 cases complicated with detrusor-sphincter dyssynergy. Fifteen cases of bladder prolapse, including 11 cases of central type and 4 cases of lateral type, and 3 cases complicated with detrusor overactivity. Ten cases of urethral diverticulum, including 1 case complicated with diverticular calculi. Conclusion VUD examination is helpful to clarify the etiology of complicated lower urinary tract infections and provides evidences for clinical treatment.
Objective To evaluate the application of video urodynamics(VUD) in female patients with complicated urinary tract infections. Methods One hundred and three female patients with complicated lower urinary tract infections underwent VUD examination,the free urinary flow rate, bladder filling period, urination function measurement and synchronous imaging display were documented. The results were analyzed to identify the etiology of complex lower urinary tract infections. Results The VUD examination revealed that there were 78 cases of bladder outlet obstruction. Thirty-nine cases complicated with detrusor overactivity and 4 cases complicated with detrusor-sphincter dyssynergy. Fifteen cases of bladder prolapse, including 11 cases of central type and 4 cases of lateral type, and 3 cases complicated with detrusor overactivity. Ten cases of urethral diverticulum, including 1 case complicated with diverticular calculi. Conclusion VUD examination is helpful to clarify the etiology of complicated lower urinary tract infections and provides evidences for clinical treatment.
引文
[1]尿路感染诊断与治疗中国专家共识编写组.尿路感染诊断与治疗中国专家共识(2015版)-复杂性尿路感染[J].中华泌尿外科杂志,2015,36(4):241-244.
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[4]Blaivas JC,Groutz A.Bladder outlet obstruction nomogram for wolllen with lower urinary tract symptomatology[J].Neurouml Urodyn,2000,19:553-564.
[5]Patel R,Nitti.V.Bladder outlet obstruction in women:Prevalence,recognition and menagenment[J].Curr Urol Rep,2001,2(5):379.
[6]张鹏,武治津,扬勇,等.影像尿动力学检查在诊断女性下尿路排尿功能障碍疾病中的应用[J].中华泌尿外科杂志,2015,50(5):438-442.DOI:10.3760/cma.j.issn.0529-5815.2012.05.013.
[7]Hoffman DS,Nitti VW.Female Bladder Outlet Obstruction[J].Curr Urol Rep,2016,17:31.DOI:10.1007/s119M-016-0586-2.
[8]徐智慧.影像尿动力学检查对女性尿道功能性梗阻的诊断价值[C].2014浙江省医学会男科学泌尿外科学学术年会论文汇编[C].2014.
[9]Jerry B,Michael B,Chancellor JW,et al.尿动力学图谱[M].吴士良,译.2版.北京:人民卫生出版社,2008:107-129.
[10]林峰,陈军,王鸿康,等.女性“前列腺增生症”的临床诊治分析[J].中国全科医学,2013,16(18):195-197.DOI:10.3969/j.issn.1007-9572.2013.01.061.
[11]Wein AJ.Re:A midurethral sling to reduee incontinence after vaginal prolapse repair[J].J Urel,2013,189(4):1445.DOI:10.1016/j.jHID.2012.12.075.
[12]金重睿,撒应龙,舒慧泉,等.女性尿道憩室的临床诊治分析[J].中华泌尿外科杂志,2017,38(10):746-750.DOI:10.3760/cma.j.issn.1000-6702.2017.10.007.
[2]Meier K,Padmanabhan P.Female bladder outlet obstruction:An update on diagnosis and management[J].Curt Opin Urol,2016,26:334-341.DOI:10.1097/mou.0000000000000303.
[3]廖利民.尿动力学技术规范(GUP)[J].中华腔镜泌尿外科杂志(电子版),2008,2(4):373.
[4]Blaivas JC,Groutz A.Bladder outlet obstruction nomogram for wolllen with lower urinary tract symptomatology[J].Neurouml Urodyn,2000,19:553-564.
[5]Patel R,Nitti.V.Bladder outlet obstruction in women:Prevalence,recognition and menagenment[J].Curr Urol Rep,2001,2(5):379.
[6]张鹏,武治津,扬勇,等.影像尿动力学检查在诊断女性下尿路排尿功能障碍疾病中的应用[J].中华泌尿外科杂志,2015,50(5):438-442.DOI:10.3760/cma.j.issn.0529-5815.2012.05.013.
[7]Hoffman DS,Nitti VW.Female Bladder Outlet Obstruction[J].Curr Urol Rep,2016,17:31.DOI:10.1007/s119M-016-0586-2.
[8]徐智慧.影像尿动力学检查对女性尿道功能性梗阻的诊断价值[C].2014浙江省医学会男科学泌尿外科学学术年会论文汇编[C].2014.
[9]Jerry B,Michael B,Chancellor JW,et al.尿动力学图谱[M].吴士良,译.2版.北京:人民卫生出版社,2008:107-129.
[10]林峰,陈军,王鸿康,等.女性“前列腺增生症”的临床诊治分析[J].中国全科医学,2013,16(18):195-197.DOI:10.3969/j.issn.1007-9572.2013.01.061.
[11]Wein AJ.Re:A midurethral sling to reduee incontinence after vaginal prolapse repair[J].J Urel,2013,189(4):1445.DOI:10.1016/j.jHID.2012.12.075.
[12]金重睿,撒应龙,舒慧泉,等.女性尿道憩室的临床诊治分析[J].中华泌尿外科杂志,2017,38(10):746-750.DOI:10.3760/cma.j.issn.1000-6702.2017.10.007.