[1]宋海峰,张庭继,于正刚,等.腰椎间盘突出症合并有下尿路症状患者临床与尿动力学研究*[J].陕西医学杂志,2019,(12):1608-1611.
　SONG Haifeng,ZHANG Tingji,YU Zhenggang,et al.Clinical and urodynamic analysis on protrusion of lumbar intervertebral disc patients with urinary voiding dysfunction[J].,2019,(12):1608-1611.
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腰椎间盘突出症合并有下尿路症状患者临床与尿动力学研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年12期
页码:
1608-1611
栏目:
临床研究
出版日期:
2019-12-05

文章信息/Info

Title:
Clinical and urodynamic analysis on protrusion of lumbar intervertebral disc patients with urinary voiding dysfunction
文章编号:
DOI:10.3969/j.issn.10007377.2019.12.008
作者:
宋海峰1; 张庭继2; 于正刚2; 夏英鹏1; 苏彦慧2; 高军伟1; 于 斌1; 关 钊2
1天津市人民医院脊柱外科（天津 300121）；2天津市人民医院泌尿外科（天津 300121）
Author(s):
SONG Haifeng; ZHANG Tingji; YU Zhenggang; et al
Department of Spinal Surgery,Tianjin Union Medical Center(Tianjin 300121)
关键词:
腰椎间盘突出; 尿动力学; 脊髓损伤; 排尿功能障碍
Keywords:
Key words Protrusion of lumbar intervertebral disc; Urodynamics; Spimd cord injury; Voiding dysfunction
分类号:
R684
文献标志码:
A
摘要:
摘 要 目的：观察腰椎间盘突出引起的下尿路症状的特点和尿动力学的变化。方法：将58例腰椎间盘突出症合并下尿路症状患者，根据椎间盘突出节段分为高位椎间盘突出组（A组，T12L3节段，26例)和低位突出组（B组，L3S1节段，32例），并根据不同椎管内容积侵占率（腰椎CT图像）、临床JOA评分评分分组，观察患者所表现的下尿路功能障碍特点和尿动力学检查情况。结果：①本组患者的下尿路症状有尿路刺激症状、尿路梗阻症状或者混合型症状。但B组中有2例不能自主排尿，而A组则没有。②根据JOA评分将其分为15分以上组（＞15分）与0～15分组；但两组均为评分较低患者占更高，两组间比较无统计学差异。③两组间在重度和轻、中度侵占率者占比比较有统计学差异。尿动力学检查发现，低位突出组残余尿量分别（361±220） ml和（1329 ±6350） ml，两者比较差异有统计学意义(P＜005)。此外，两组的膀胱顺应性间数值分别为1950（162～498）ml/cmH2O和440（302～634）ml/cmH2O，两者比较差异有统计学意义(P＜005)。结论：高位和低位腰椎间盘突出均可出现下尿路功能障碍表现，且椎管侵占严重者、临床评估神经功能评分较低者所占比例更高。高位腰椎间盘突出患者低顺应性膀胱发生率较高；而低位腰椎间盘突出症高顺应性膀胱发生率较高，可发生尿潴留。
Abstract:
Abstract Objective:To investigate the clinical features of bladder and urethra dysfunction protrusion of lumbar intervertebral disc patients with urinary voiding dysfunction，and to find Clinical value of urodynamicsMtthods:A total of 58 patients 26 cases higher level protrusion（group A）and 32 cases lower level protrusion (group B)were recruited in，according to the eriteria of inclusion and exclusionThe patients were classifled into different groups,according to JOA scores and ratios of spinal canal encroachmentA rerrospective analysis of the clinical features and urodynamic data of the patients were conductedReslult:Urinary tract irritation symptoms,and symptoms of urinary tract obstruction were found in the two groups,and 2 cases of inability to urinate autonomously were found in group APatients of lower JOA scores took a higher proportion in both groupsPatients of with mild and moderate ratios of spinal canal encroachment took a higher proportion in group A in contrast to I group BThe residual urine volumes (361±220ml) of group A were statistical different between those(1329 ±6350 ml)The incidence of low compliance bladder in the group A is 4/26,and the incidence of high compliance bladder in the sacral is 11/22Concluslon:Urinary tract irritation symptoms,and symptoms of urinary tract obstruction were found in lumbar intervertebral disc patients with urinary voiding dysfunction,no matterwhich levelThe urodynamics difference between different level protrusion of lumbar disk were observed in bladder compliance and residual urine volumesUrodynamics may be potential value for Prognostic evaluation

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备注/Memo

备注/Memo:
*天津市卫生局科技资助项目（2013KZ138）
更新日期/Last Update: 2019-12-19