脊髓损伤患者神经源性膀胱尿动力学研究的正常变异范围。
Normal ranges of variability for urodynamic studies of neurogenic bladders in spinal cord injury.
作者信息
Chou Franklin H, Ho Chester H, Chir M B, Linsenmeyer Todd A
机构信息
Department of Urology, Kessler Institute for Rehabilitation, West Orange, New Jersey 07052, USA.
出版信息
J Spinal Cord Med. 2006;29(1):26-31. doi: 10.1080/10790268.2006.11753853.
BACKGROUND/OBJECTIVE: Urodynamic studies are conducted on a regular basis to evaluate changes in bladder function after spinal cord injury. Often, differences in urodynamic parameters exist from one study or one year to the next. The objective of this study was to provide reference ranges for "normal" variability in urodynamic parameters that can be considered as "no real change" from one study to the next.
DESIGN
Retrospective chart review.
METHODS
Fifty consecutive individuals with spinal cord injury had 2 trials (trial 1 and trial 2) of urodynamic studies done 5 minutes apart, and the following data were collected: maximum cystometric capacity, opening pressure, maximum detrusor pressure, volume voided, and postvoid residual. The corresponding data were compared, and the frequency distribution for the change between consecutive studies was plotted. Because there is no standard, variability ranges for 5th to 95th, 10th to 90th, and 25th to 75th percentiles were calculated to give health care providers more choices.
RESULTS
Ranges of variability are as follows in the following format (urodynamic parameter; mean value; +, maximum increase; -, maximum decrease)--5th to 95th percentile: cystometric capacity (234.63 mL, +213.50 mL, -158.05 mL); opening pressure (54.56 cmH2O, +30 cmH2O, -18.00 cmH2O); maximum detrusor pressure (60.82 cmH2O, +17.35 cmH2O, -27.80 cmH2O); volume voided (122.20 mL, +177.25 mL, -176.00 mL); postvoid residual (176.06 mL, +197.25 mL, -118.00 mL); 10th to 90th percentile: cystometric capacity (234.63 mL, +126.40 mL, -74.60 mL); opening pressure (54.56 cmH2O, +13.70 cmH2O, -12.00 cmH2O); maximum detrusor pressure (60.82 cmH2O, +10.00 cmH2O, -20.00 cmH2O); volume voided (122.20 mL, +105.60 mL, -82.00 mL); postvoid residual (176.06 mL, +131.00 mL, -86.00 mL); 25th to 75th percentile: cystometric capacity (234.63 mL, +72.00 mL, -27.00 mL); opening pressure (54.56 cmH2O, +4.00 cmH2O, -9.50 cmH2O; maximum detrusor pressure (60.82 cmH2O, +4.00 cmH2O, -10.00 cmH2O); volume voided (122.20 mL, +50.00 mL, -30.00 mL); postvoid residual (176.06 mL, +50.00 mL, -30.00 mL).
CONCLUSIONS
Urodynamic studies have variability. Knowing these ranges of variability can be helpful in determining whether differences between filling trial 1 and filling trial 2 in a single study or year-to-year changes in urodynamic studies are significant or simply the normal variability of the urodynamic study.
背景/目的：定期进行尿动力学研究以评估脊髓损伤后膀胱功能的变化。通常，一项研究与另一项研究或不同年份之间的尿动力学参数存在差异。本研究的目的是提供尿动力学参数“正常”变异性的参考范围，这些变异性可被视为一项研究与另一项研究之间“无实际变化”。
设计
回顾性图表审查。
方法
连续50例脊髓损伤患者进行了两次间隔5分钟的尿动力学研究（试验1和试验2），并收集了以下数据：最大膀胱测压容量、起始压力、最大逼尿肌压力、排尿量和残余尿量。对相应数据进行比较，并绘制连续研究之间变化的频率分布。由于没有标准参考，计算了第5至95百分位、第10至90百分位和第25至75百分位的变异性范围，以便为医疗保健提供者提供更多选择。
结果
变异性范围如下（尿动力学参数；平均值；+，最大增加量；-，最大减少量）——第5至95百分位：膀胱测压容量（234.63 mL，+213.50 mL，-158.05 mL）；起始压力（54.56 cmH₂O，+30 cmH₂O，-18.00 cmH₂O）；最大逼尿肌压力（60.82 cmH₂O，+17.35 cmH₂O，-27.80 cmH₂O）；排尿量（122.20 mL，+177.25 mL，-176.00 mL）；残余尿量（176.06 mL，+197.25 mL，-118.00 mL）；第10至90百分位：膀胱测压容量（234.63 mL，+126.40 mL，-74.60 mL）；起始压力（54.56 cmH₂O，+13.70 cmH₂O，-12.00 cmH₂O）；最大逼尿肌压力（60.82 cmH₂O，+10.00 cmH₂O，-20.00 cmH₂O）；排尿量（122.20 mL，+105.60 mL，-82.00 mL）；残余尿量（176.06 mL，+131.00 mL，-86.00 mL）；第25至75百分位：膀胱测压容量（234.63 mL，+72.00 mL，-27.00 mL）；起始压力（54.56 cmH₂O，+4.00 cmH₂O，-9.50 cmH₂O；最大逼尿肌压力（60.82 cmH₂O，+4.00 cmH₂O，-10.00 cmH₂O）；排尿量（122.20 mL，+50.00 mL，-30.00 mL）；残余尿量（176.06 mL，+50.00 mL，-30.00 mL）。
结论
尿动力学研究存在变异性。了解这些变异性范围有助于确定在一项研究中充盈试验1和充盈试验2之间的差异或尿动力学研究的逐年变化是显著的还是仅仅是尿动力学研究的正常变异性。
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