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基于个人设备辅助的新型可移动尿动力学监测系统在脊髓损伤患者中的应用。

Availability of a newly devised ambulatory urodynamics monitoring system based on personal device assistance in patients with spinal cord injury.

机构信息

School of Electronics and Information Engineering, Chonbuk National University, 664-14, 1Ga, Deokjin-dong, Jeonju, Jeonbuk 561-756, Republic of Korea.

出版信息

Comput Methods Programs Biomed. 2012 Jun;106(3):260-73. doi: 10.1016/j.cmpb.2010.10.008. Epub 2010 Nov 10.

Abstract

Conventional urodynamics systems have been widely used for the assessment of bladder functions. However, they have some drawbacks due to the unfamiliar circumstances for the patient, restrictive position during the test, expense and immovability of the instrument as well as the unphysiological filling of the bladder. To mitigate these problems, we developed a fully ambulatory urodynamics monitoring system, which enables the abdominal pressure to be measured in a non-invasive manner, as well as the manual recording of various events such as the bladder sensations or leakage of urine. Conventional (CMG) and furosemide-stimulated filling cystometry (FCMG) were performed for 28 patients with neurogenic bladders caused by spinal cord injury (24 males and 4 females, age: 49.4 ± 13.9 years, BMI: 23.5 ± 2.4). There were high correlation coefficients (r=0.97 ± 0.02) between the clinical parameters measured by the conventional rectal catheter and those measured by our non-invasive algorithm in the FCMG studies. Also, 10 of the patients (36%) were diagnosed as having different reflexibility of the bladder between conventional CMG and FCMG (p<0.05). In the patients with detrusor overactivity, the average volume and detrusor pressure at bladder sensation in FCMG were lower than those in CMG, while the average compliance was higher (p<0.05). In the patients with areflexic bladders, the number of patients with detrusor overactivity was higher in FCMG and leakage was observed more frequently. These results showed that our system could be a useful additional tool in the clinical assessment of patients in which conventional cystometry failed to explain their symptoms.

摘要

传统的尿动力学系统已广泛用于评估膀胱功能。然而,由于患者对环境不熟悉、测试时体位受限、仪器昂贵且不能移动以及膀胱非生理性充盈等原因,它们存在一些缺点。为了解决这些问题,我们开发了一种完全可移动的尿动力学监测系统,该系统能够以非侵入性的方式测量腹内压,并手动记录各种事件,如膀胱感觉或尿液泄漏。对 28 例因脊髓损伤导致的神经性膀胱患者(24 名男性和 4 名女性,年龄:49.4 ± 13.9 岁,BMI:23.5 ± 2.4)进行了常规(CMG)和速尿刺激充盈膀胱测压(FCMG)。FCMG 研究中,我们的非侵入性算法测量的临床参数与传统直肠导管测量的参数之间存在高度相关系数(r=0.97 ± 0.02)。此外,10 名患者(36%)在常规 CMG 和 FCMG 之间存在不同的膀胱反射性(p<0.05)。在逼尿肌过度活动患者中,FCMG 中膀胱感觉时的平均容量和逼尿肌压低于 CMG,而平均顺应性更高(p<0.05)。在无反射性膀胱患者中,FCMG 中逼尿肌过度活动患者的数量更多,漏尿更频繁。这些结果表明,我们的系统可能是一种有用的附加工具,可用于对常规膀胱测压无法解释其症状的患者进行临床评估。

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