资源描述:
《非侵入性尿动力学检查评估小儿膀胱功能的分析》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、遭受侵入性检查的痛苦。材料和方法选取2011年7月到2013年7月在我院就诊的下尿路功能障碍的儿童和青少年155例。其屮,男106例,女49例;年龄5〜18岁,平均(10.46±3.55)岁。记录患儿病史、排尿FI记和体格检查,按照国际小儿尿控协会(InternationalChildrenContinenceSociety,1CCS)的标准分别进行自由尿流率和彩超测定残余尿等NIUDS,以及膀胱测压等IUDS。依据自由尿流率和PVR将逼尿肌功能分为增强、正常和活动低下,并结合患儿病史、排尿日记和体格检查等
2、做出NIUDS诊断,并与IUDS结果进行比较。采用SPSS17.0统计学软件包进行统计学分析,定量资料用(=土s)表示,定性资料用百分比表示。率的比较采用卡方检验,P<0.05认为差异有统计学意义。结果N1UDS和IUDS的结果分别为增强54/26例,正常74/98例,活动低下27/31例。两种方法评估膀胱逼尿肌功能的结果,差异有统计学意义(PV0.05),增强时两种方法的差界有统计学意义(PV0.05),活动低下时差界无统计学意义(P>0.05)oNIUDS评估逼尿肌收缩功能增强时的敏感性、特异性和准确率
3、分别为77%(20例/26例)、74%(95例/129例)和74%(115例/155例);正常时分别为62%(61例/98例)、77%(44例/57例)和68%(105例/155例);活动低下时分别为81%(25例/31例)、98%(122例/124例)和95%(147例/155例)o结论NIUDS评估逼尿肌活动低下的敏感性和特异性较好,但不能完全替代IUDS,可作为筛查膀胱功能的首选方法。关键词尿动力学排尿障碍评价研究尿流率残余尿Acomparativestudyofnoninvasiveandinvas
4、iveurodynamicassessmentofbladderdysfunctioninChildrenPostgraduate:XinmeiGaoSupervisor:WenJianGuoTheFirstAffiliatedHospitalofZhengzhouUniversityZhengzhou,China,450052AbstractBackgroundandpurposeLowerurinarytractdysfunction(LUTD)isacommondiseaseinchildren,an
5、dmaypresenturinaryincontinence,urinarytractinfection,vesicoureteralreflux(VUR)and/orintestinalconstipation.Epidemiologicalstudyshowedtheratesofurinaryincontinenceandenuresisashighas10%inschool-agechildren.Itmayinfluencechildren^qualityoflife,effectthestudy
6、andnormalgrowupinfuture.AccordingtotheInternationalContinenceSociety(ICS)definition,thesechildrenshouldusesomemethodstogiveinformationoflowerurinarytract,suchasvoidinghistory,physicalexamination,voidingdiaryandurodynamicstudy.Theurodynamicstudy(UDS)hasbeco
7、mecommonpracticeintheevaluationofinfantsandchildrenwithbladderdysfunction.Ithastheabilitytogivetheetiologydiagnosisandevidence-basedprogramsfortherapy.Theurodynamicstudyconsistofinvasiveurodynamicstudy(IUDS)andnoninvasiveurodynamicstudy(NIUDS).Itiswellknow
8、nthatinvasiveurodynamicStudy(IUDS)isthegoldstandardforevaluationofbladderdysfunction.However,itssideeffectsarepain,hematuriaanddiscomfort,occasionaldifficulttoperform,althoughsometimesthereasonisfearandun-coo