DOI：10.16016/j.1000-5404.201410042膀胱尿道压力同步测定评估女性压力性尿失禁的初步研究张艳1,文建国1,蔡腾2,任川川二崔林刚：吕宇涛：张瑞莉1(450052郑州，郑州大学第一附属医院泌尿外科，尿动力学中心；450003郑州，河南省人民医院急诊创伤外科釣［摘要］目的探讨膀胱尿道压力同步测定评估女性压力性尿失禁的应用价值。方法选取35例女性压力性尿失禁(stressurinaryincontinence,SUI)患者，年龄(49.5±&6)岁，同时选取34例排尿功能正常的女性患者(4&4±10.3)岁作为对照组。根据国际尿控协会规定的尿动力检查方法采用MMS尿动力检查仪对两组患者进行膀胱尿道压力同步测定。观察参数包括：充盈期尿道闭合压(fillingurethralclosurepressure.UCPmi)、Valsaval动作时尿道闭合压(urethralclosepressure,UCP)、腹压传导率(pressuretransmissionratio,PTR)>最大尿流率时的尿道闭合压(voidingurethralclosepressure,UCPvoid)o结果两组患者充盈过程中未增加腹压时尿道闭合压为正值，且充盈期前和充盈期末UCPmi没有明显改变(P>0.05),但SUI组UCPmi明显低于对照组(P<0.05)。行Valsaval动作时，SUI组尿道闭合压降为负值且腹压传导率W100%,而对照组尿道闭合压仍保持正值，腹压传导率大于100%,两组UCP和PTR差异均有统计学意义(戶<0.05)。排尿期SUI组和对照组膀胱压升高，尿道压同步降低，最大尿道闭合压为负值，两组间UCPvoid无明显差异(D0.05)。结论膀胱尿道压力同步测定是判断膀胱尿道协调功能的有效方法。SUI患者膀胱充盈期尿道闭合压低、增加腹压时尿道闭合压为负值和腹压传导率W100%可以作为提示发生压力性尿失禁的客观依据。［关键词］膀胱尿道压力同步测定；女性；压力性尿失禁；最大尿道闭合压［中图法分类号］［文献标志码］APreliminaryStudyofBladderandUrethraSynchronousManometryinAssessmentofFemaleStressUrinaryIncontinenceZhangYan1,WenJianguo1,CaiTcng［RenChuanchuan1,CuiLingang1,LvYutao1,ZhangRuili1(UrodynamicCenter,DepartmentofUrology1,FirstAffiliatedHospital,ZhengzhouUniversity,Zhengzhou,450052,China;DepartmentofTrauma2,HenanProvincePeople'sHospital,Zhengzhou,450003,China)［Abstract］ObjectiveToexploretheapplicationofbladderandurethrasynchronousmanometry(BUSM)intheassessmentoffemalestressurinaryincontinence(SUI)・MethodsThirty・fivewomen(49・5±8・6years-old)diagnosedwithSUIwereincludedintheSUIgroup,andthirty・fourwomenwithoutvoidingdysfunction(48.4±10.3years-old)wereselectedasthecontrolgroup(NSUIgroup).BUSMwascarriedoutinallwomenaccordingtothestandardsproposedbytheInternationalContinenceSociety.Theobservationparametersincludedfillingurethralclosurepressure(UCPtm),averageurethralclosurepressure(UCP)invalsavalmaneuver,pressuretransmissionratio(PRT),andvoidingurethralclosurepressure(UCPVoid)-ResultsDuringthefillingprocess,thestaticurethralpressurewashigherthanbladderpressureintheSUIandNSUIgroups,andtherewasnochangeofUCPnnatthebeginningandatlast(P>0.05),however,theUCPfinoftheSUIgroupwasobviouslylowerthanthatoftheNSUIgroup(P<0.05).Whenthepatientsdidvalsavalmaneuver,theUCPwasnegativeandPTRwas100%orlessintheSUIgroup,whiletheUCPremainedpositiveandPRTwasgreaterthan100%intheNSUIgroup,andtheUCPandPTRbetweentheSUIandNSUIgroupshadstatisticalsignificance(P<0.05).Inthevoidingphase,thebladderpressureincreasedwhileurethralpressuredecreased,andthemaximalurethralclosurepressurewasnegative,buttherewasnodifferenceinUCPvoidbetweentheSUIandNSUIgroups(P>0.05).ConclusionsBUSMisaneftectivemeasurementtoassessthecoordinationfunctionofthebladderandurethra・ThelowerUCPfin,PRT<100%andnegativeUCPcanprovidevaluablereferencesfordiagnoseofSUL［Keywords］bladderandurethrasynchronousmanometry;female;stressurinaryincontinence;maximalur...