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目的 :研究脑卒中后尿失禁患者尿动力学异常 ,并与前列腺增生症、腰骶髓病变排尿异常进行比较。方法 :脑卒中后尿失禁患者 40例 ,腰骶髓病变患者 9例 ,前列腺增生患者 2 2例。患者均行尿动力学检查 ,分析膀胱尿道功能。结果 :脑卒中后尿失禁主要尿动力学异常为逼尿肌反射亢进 ( 70 0 % ) ,尿道外括约肌无抑制性松弛 ( 3 7 5 % )。与逼尿肌反射亢进相关的主要病变为额叶和基底节。与腰骶髓病变、前列腺增生组尿动力学异常有显著差异。结论 :脑卒中后尿失禁患者尿动力学改变以逼尿肌反射亢进和尿道外括约肌无抑制性松弛为主。
Objective: To investigate urodynamic abnormalities in patients with post-stroke urinary incontinence and to compare with those of prostatic hyperplasia and lumbosacral lesions. Methods: 40 cases of post-stroke urinary incontinence, 9 cases of lumbosacral disease and 22 cases of benign prostatic hyperplasia. Patients underwent urodynamic examination, analysis of bladder and urethral function. RESULTS: The major urodynamic abnormalities in post-stroke urinary incontinence were detrusor hyperreflexia (70%) and no inhibition of relaxation (357%) in the external urethral sphincter. The major lesions associated with detrusor hyperreflexia are frontal and basal ganglia. And lumbosacral lesions, benign prostatic hyperplasia urodynamic abnormalities were significantly different. Conclusion: Urodynamic changes in patients with post-stroke urinary incontinence are mainly detrusor hyperreflexia and non-inhibitory relaxation of the external urethral sphincter.