“液桥试验”联合腹压漏尿点压评估女性压力性尿失禁的意义

来源 :第十三届亚洲泌尿外科学会年会(UAA2015)、第二十二届全国泌尿外科学术会议(CUA2015)、第十六届全军及武警泌尿 | 被引量 : 0次 | 上传用户:rongcs
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比较压力性尿失禁与正常控尿女性"液桥试验"和腹压漏尿点压(LPP),了解"液桥试验"联合LPP诊断压力性尿失禁及判断尿道功能的价值.选取我院尿动力中心检查的50例(Ⅰ组)有临床压力性尿失禁表现女性患者作为试验组,年龄31 ~ 81(45±9)岁,尿失禁症状持续2个月至36年;及其它原因需要手术留置尿管但无下尿路症状的女性患者35例作为对照组(Ⅱ组),年龄27 ~ 75 (43±7)岁.按照国际尿控协会推荐的标准方法进行尿动力学测定,并同时进行液桥试验和LPP测定检查.比较两组患者的液桥试验阳性率及液桥试验阳性患者膀胱压力增高值与尿道压力增高值的差值(ΔP)的差异,并比较其他相关尿动力学参数.有压力性尿失禁症状患者LPP测定确诊46例(46/50),液桥试验阳性44例(44/50);对照组LPP检测均未测出漏尿现象,发生液桥试验阳性(2/35).液桥试验诊断SUI的灵敏度为0.88,特异度为0.94,液桥试验联合LPP诊断SUI的灵敏度为0.94,特异度为0.97.SUI组44例发生液桥试验阳性的患者中Ⅰ型压力性尿失禁11例,Ⅱ型12例,Ⅱ/Ⅲ型9例,Ⅲ型12例.Ⅰ型压力性尿失禁患者中ΔP为(11.0±2.6)cmH2O(1组),Ⅱ型ΔP(19.6±4.3) cmH2O(2组),Ⅱ/Ⅲ型ΔP(35.2±9.1)cmH2O(3组),Ⅲ型ΔP(49.7±9.3) cmH2O(4组).1组与2组无明显差异(P>0.0125),余组间比较均有明显差异(P<0.0125),呈递增趋势.液桥试验联合LPP测定可作为诊断SUI并判断尿道功能缺失有用的尿流动力学手段.液桥试验在LPP的基础上可以根据尿道功能的缺失程度将SUI的分型细化,两者联合可以判定膀胱尿道的协同作用,对于评估SUI患者的下尿路功能有着重要意义.
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