Lu Tianji, Liao Limin
Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, China.
Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China.
Int Neurourol J. 2016 Sep;20(3):214-223. doi: 10.5213/inj.1632556.278. Epub 2016 Sep 23.
The goal of this study was to establish typical value ranges (TVRs) and to analyze typical signal patterns (TSPs) of the initial cough (cough before bladder filling) for quality control in urodynamic studies.
A total of 539 urodynamic traces from patients with neurogenic bladder obtained over the course of a year were retrospectively reviewed. The TVRs for cough amplitude in measurements of the intravesical pressure (P), abdominal pressure (P), and detrusor pressure (P) during the initial cough were established. We used the 95% range as a reference range for all parameters. Cough spikes in P were described and classified, and the reasons for different patterns of cough spikes were established. The quality of all the cystometry traces was checked, and we also present remedial actions for inappropriate cough spikes.
The cough amplitudes in the measurements of P and P were similar, with 95% of measurements falling within the following ranges: 4-62 cm HO and 3-70 cm HO, respectively, in supine position and 9-95 cm HO and 8-98 cm HO, respectively, in sitting position. For P, the cough amplitude ranged from -38 to 25 cm HO in supine position and from -44 to 41 cm HO in sitting position. The cough spikes for P were classified as follows: type I, P pressure exhibited a minimal change (<5 cm HO) during the cough; type II, a monophasic spike (>5 cm HO) was observed for P; and type III, biphasic spikes were observed for P. Type I coughs were found to have more high-quality traces (P<0.01).
TVRs for the initial cough test among neurogenic patients were established in order to provide guidelines for quantitative quality control. The TSPs for the initial cough signal were described, and the presence of a high-quality cough signal may be recommended as a component of quality control in urodynamic measurements.
本研究的目的是建立典型值范围（TVRs），并分析初始咳嗽（膀胱充盈前咳嗽）的典型信号模式（TSPs），以用于尿动力学研究的质量控制。
回顾性分析了一年内从神经源性膀胱患者获得的539条尿动力学记录。建立了初始咳嗽期间膀胱内压（P）、腹压（P）和逼尿肌压（P）测量中咳嗽幅度的TVRs。我们将95%范围用作所有参数的参考范围。描述并分类了P中的咳嗽峰值，并确定了不同咳嗽峰值模式的原因。检查了所有膀胱测压记录的质量，我们还提出了针对不适当咳嗽峰值的补救措施。
P和P测量中的咳嗽幅度相似，95%的测量值分别在仰卧位时落在以下范围内：4 - 62 cm HO和3 - 70 cm HO，坐位时分别为9 - 95 cm HO和8 - 98 cm HO。对于P，仰卧位时咳嗽幅度范围为 - 38至25 cm HO，坐位时为 - 44至41 cm HO。P的咳嗽峰值分类如下：I型，咳嗽期间P压力变化最小（<5 cm HO）；II型，观察到P出现单相峰值（>5 cm HO）；III型，观察到P出现双相峰值。发现I型咳嗽有更多高质量记录（P<0.01）。
建立了神经源性患者初始咳嗽试验的TVRs，以便为定量质量控制提供指导。描述了初始咳嗽信号的TSPs，并且可以推荐高质量咳嗽信号的存在作为尿动力学测量质量控制的一个组成部分。
