Moore K, Griffiths D, Latimer G, Merke R
J ET Nurs. 1993 Jul-Aug;20(4):163-8.
We wished to determine whether 24-hour monitoring of urinary incontinence without video urodynamics would provide adequate information for treatment. Twelve subjects with urinary incontinence (seven women and five men) were investigated, average age 75 years (range 44 to 89 years). Setting was a community hospital (80 beds), a nursing home, and a lodge, 60 miles from the nearest assessment center. Twenty four-hour monitoring consisted of 2 hourly preweighed pad changes, postchange weighing, Uroflow set-up in subject's bathroom, fluid intake record, and 1 postvoid residual ultrasonogram. All subjects had history and physical and evaluation of medications. Findings included probable urge incontinence, stress incontinence, chronic retention with overflow, and normal bladder function. Recommendations included oxybutynin chloride, timed toileting, timed fluid restriction, diuretic manipulation, intermittent catheterization, pessary, and surgery. At 6 weeks, 25% (4/12) were better (three with urge incontinence and one after operation for stress incontinence). Video urodynamics were conducted only for the patient with stress incontinence after operation. We suggest that 24-hour monitoring is noninvasive, is less disruptive and less expensive than video urodynamics, and provides adequate information for initial treatment in many patients with urinary incontinence.
我们希望确定在不进行影像尿动力学检查的情况下，对尿失禁进行24小时监测是否能为治疗提供足够的信息。对12名尿失禁患者（7名女性和5名男性）进行了调查，平均年龄75岁（范围44至89岁）。调查地点包括一家社区医院（80张床位）、一家养老院和一个旅馆，距离最近的评估中心60英里。24小时监测包括每两小时更换一次预先称重的尿垫、更换后称重、在患者浴室设置尿流计、记录液体摄入量以及一次排尿后残余尿量超声检查。所有受试者均有病史、体格检查及用药评估。检查结果包括可能的急迫性尿失禁、压力性尿失禁、慢性尿潴留伴充溢性尿失禁以及正常膀胱功能。建议包括使用氯化奥昔布宁、定时如厕、定时限制液体摄入、调整利尿剂、间歇性导尿、使用子宫托以及手术治疗。6周时，25%（4/12）的患者病情好转（3例急迫性尿失禁患者和1例压力性尿失禁手术后患者）。仅对压力性尿失禁手术后的患者进行了影像尿动力学检查。我们认为，24小时监测是非侵入性的，比影像尿动力学检查干扰性小且费用低，并且能为许多尿失禁患者的初始治疗提供足够的信息。
