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儿童瓣膜性膀胱综合征的尿动力学研究

Urodynamic investigation of valve bladder syndrome in children.

作者信息

Wen Jian Guo, Li Yuan, Wang Qing Wei

机构信息

The Pediatric Urodynamic Center, Department of Paediatric Surgery, First Teaching Hospital of Zhengzhou University, Institute of Clinical Medical Research Universities, No.1, Jianshe East Road, Henan Province, Zhengzhou City 450052, China.

出版信息

J Pediatr Urol. 2007 Apr;3(2):118-21. doi: 10.1016/j.jpurol.2006.06.008. Epub 2006 Aug 21.

Abstract

OBJECTIVE

To investigate urodynamic manifestations and their relationship with the postoperative experience of children with valve bladder syndrome (VBS).

METHODS

Included were 16 children (mean age 3.2+/-1.8 years) with VBS, who were divided into two groups. The urodynamic study was performed less than 1 year in group 1 (seven boys, aged 1-1.9 years) and more than 1 year in group 2 (nine boys, aged 2.9-6.5 years) after urethral valve fulguration; at the time of operation patients were less than 2 years old. Standards of the International Children's Continence Society were respected, and results were compared between the two groups.

RESULTS

Compared to group 1, group 2 showed a significant decrease in maximum detrusor voiding pressure (Pdet.void.max) and bladder compliance (BC), and an increase in post-voiding residual (PVR) and maximum bladder capacity (MBC) (p<0.05), but the difference in detrusor instability was not significant (p>0.05), Pdet.void.max and PVR were 56.2+/-14.1 cmH(2)O and 96.6+/-52.4 ml, respectively, in group 2, and there were more intermittent detrusor contractions during voiding in this group.

CONCLUSION

Patients with VBS frequently present with multiple bladder dysfunctions that can be diagnosed accurately using urodynamics. Even after urethral valve fulguration Pdet.void.max and BC were inclined to decrease, while PVR and MBC increased with the growth of the children.

摘要

目的

探讨瓣膜膀胱综合征(VBS)患儿的尿动力学表现及其与术后体验的关系。

方法

纳入16例VBS患儿(平均年龄3.2±1.8岁),分为两组。第1组(7名男孩,年龄1 - 1.9岁)在尿道瓣膜电灼术后1年内进行尿动力学研究,第2组(9名男孩,年龄2.9 - 6.5岁)在术后1年以上进行尿动力学研究;手术时患者年龄小于2岁。遵循国际儿童尿控协会的标准,比较两组结果。

结果

与第1组相比,第2组最大逼尿肌排尿压力(Pdet.void.max)和膀胱顺应性(BC)显著降低,排尿后残余尿量(PVR)和最大膀胱容量(MBC)增加(p<0.05),但逼尿肌不稳定的差异不显著(p>0.05),第2组Pdet.void.max和PVR分别为56.2±14.1 cmH₂O和96.6±52.4 ml,且该组排尿期间间歇性逼尿肌收缩更多。

结论

VBS患者常出现多种膀胱功能障碍,可通过尿动力学准确诊断。即使在尿道瓣膜电灼术后,Pdet.void.max和BC仍倾向于降低,而PVR和MBC随患儿生长而增加。

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