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脊髓损伤患者膀胱壁厚度与尿动力学检查结果之间的关联

Association between the bladder wall thickness and urodynamic findings in patients with spinal cord injury.

作者信息

Silva Jose Ailton Fernandes, Gonsalves Marcia de Castro Diniz, de Melo Rogerio Teles, Carrerette Fabricio Borges, Damião Ronaldo

机构信息

State University of Rio de Janeiro, Rio de Janeiro, Brazil,

出版信息

World J Urol. 2015 Jan;33(1):131-5. doi: 10.1007/s00345-014-1265-x. Epub 2014 Feb 27.

Abstract

PURPOSE

To investigate whether ultrasonographic bladder wall thickness (BWT) correlates with urodynamic parameters in patients with spinal cord injury (SCI).

METHODS

Two hundred and seventy-two patients with SCI were enrolled in the study. All of the patients underwent bladder ultrasonography and urodynamic study. The anterior bladder wall was measured and compared to urodynamic data.

RESULTS

The mean age of the patients was 37.4 years. The mean BWT was 3.9 mm. BWT was significantly higher in the patients with neurogenic detrusor overactivity associated with detrusor sphincter dyssynergia (NDO/DSD) compared to those without sphincter dyssynergia (4.2 vs. 3.6 mm, respectively, p < 0.001) and in those with compliance <20 ml/cm H2O. Nevertheless, ROC curve analysis [ROC = 0.624, 95 % CI (0.530, 0.718), p = 0.011] showed that no meaningful BWT measurement cutoff could be made to predict an elevated detrusor pressure in the storage phase.

CONCLUSIONS

Increased BWT was present in patients with low bladder compliance and NDO/DSD. No BWT cutoff value to predict an elevated detrusor pressure was found. Therefore, the measurement of BWT has no clinical role in patients with SCI and cannot replace urodynamic evaluation.

摘要

目的

探讨脊髓损伤(SCI)患者的超声膀胱壁厚度(BWT)与尿动力学参数之间是否存在相关性。

方法

272例SCI患者纳入本研究。所有患者均接受膀胱超声检查和尿动力学检查。测量膀胱前壁厚度并与尿动力学数据进行比较。

结果

患者的平均年龄为37.4岁。平均BWT为3.9mm。与无括约肌协同失调的患者相比,伴有逼尿肌括约肌协同失调的神经源性逼尿肌过度活动(NDO/DSD)患者的BWT显著更高(分别为4.2mm和3.6mm,p<0.001),且膀胱顺应性<20ml/cm H2O的患者BWT也更高。然而,ROC曲线分析[ROC=0.624,95%CI(0.530,0.718),p=0.011]表明,无法通过有意义的BWT测量临界值来预测储尿期逼尿肌压力升高。

结论

膀胱顺应性低和NDO/DSD的患者BWT增加。未发现可预测逼尿肌压力升高的BWT临界值。因此,BWT测量在SCI患者中无临床作用,不能替代尿动力学评估。

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