Fan Liu-Bo, Ma Li-Zhong, Tian Ying
Department of Rehabilitation Medicine, Linhai District of Taizhou Hospital, Taizhou 317000, Zhejiang, China.
Zhongguo Gu Shang. 2010 Apr;23(4):285-7.
To explore the clinical value of urodynamic study in patients with neurogenic bladder by pelvic fracture postoperative.
Postoperative 12 cases with pelvic fracture resulted in uroschesis, there were 8 males and 4 females,and age from 26 to 70 years with an average of 46.5 years. Urodynamic study was done in patients at 1 d,1,3 weeks after operation and compared with 12 cases normal subjects.
There was a significant relationship between urodynamic parameter (including residual urine volume of bladder, max free flow, urethral closing pressure in filling end and so on) and course of disease. The residual urine volume of bladder and urethral closing pressure in filling end increased of urodynamic tests in all patients with uroschesis as compared with the normal subjects (P < 0.05); but max free flow decreased at 1 d, 1, 3 weeks after operation (P < 0.05). In the patients with uroschesis, residual urine volume of bladder markedly increased (P < 0.05) and urethral closing pressure in filling end markedly depressed (P < 0.05) at 1 week after operation than other time (at 1 d, 3 weeks after operation), but max free flow had not significant difference (P > 0.05).
Urodynamic study might evaluate regenerate the degree of neurogenic bladder by pelvic fracture postoperative and predict the prognosis of the neurogenic bladder.
探讨尿动力学检查在骨盆骨折术后神经源性膀胱患者中的临床应用价值。
骨盆骨折术后发生尿潴留患者12例，其中男性8例，女性4例，年龄26～70岁，平均46.5岁。分别于术后1天、1周、3周对患者进行尿动力学检查，并与12例正常受试者进行比较。
尿动力学参数（包括膀胱残余尿量、最大自由尿流率、充盈期末尿道闭合压等）与病程有显著相关性。所有尿潴留患者尿动力学检查的膀胱残余尿量及充盈期末尿道闭合压均高于正常受试者（P<0.05）；但术后1天、1周、3周最大自由尿流率降低（P<0.05）。尿潴留患者术后1周膀胱残余尿量明显增加（P<0.05），充盈期末尿道闭合压明显降低（P<0.05），与其他时间点（术后1天、3周）比较，最大自由尿流率差异无统计学意义（P>0.05）。
尿动力学检查可评估骨盆骨折术后神经源性膀胱的恢复程度，并预测神经源性膀胱的预后。
