摘要
目的:通过胸腰段脊髓损伤伴排尿障碍患者的尿流动力学检查,结合临床神经体征探究其诊断和评估的价值。方法:检查于2001-05/2002-11在北京军区总医院完成。纳入同期北京军区总医院骨科13例胸腰段脊髓损伤伴排尿障碍的住院患者。对13例患者进行包括残余尿量、膀胱容量及顺应性、逼尿肌外扩约肌协调、逼尿肌反射等方面尿流动力学检查,并采用感觉平面、双下肢肌力、会阴反射、排尿状况、临床诊断定位等临床神经体征对比,对不同部位和程度的神经损伤会引起下尿道尿流动力学指标相应的不同变化进行观察。结果:按实际处理分析,13例患者均进入结果分析。①13例患者受损的脊髓、圆锥、马尾神经的具体部位不同,临床查体和尿流动力学检查结果也不同。②每例患者临床神经系统检查与尿流动力学检查资料相比较,所得出的有关神经损伤部位的判断基本一致。结论:尿动力学检查在临床应用时可作为判断脊髓损伤部位的一个参考指标。
AIM： To investigate the diagnostic and evaluation significance of urodynamic test through that in patients with thoracolumbar spinal injury accompanied by dysuria in combination with clinical neurological physical signs. METHODS： The examination was completed in the Chinese PLA General Hospital of Beijing Military Area Command between May 2001 and November 2002.Thirteen inpatients with thoracolumbar spinal injury accompanied by dysuria in the Department of Orthopaedics were involved, they received urodynamic tests including amount of residual urine, volume and compliance of bladder,detrusor muscle-external sphincter coordination, detrusor reflex,etc.,and comparison of neurological physical signs including sensory block, muscle force of both lower limbs, reflex perineum, miction, clinical diagnostic location, etc., and the different corresponding changes of urodynamic indexes of urinary tract caused by nerve injuries at different site and of different severity were observed. RESULTS： According to the analysis of actual treatment, all the 13 patients were involved in the analysis of results. ① The specific sites of injured spinal cord, conus and pinal nerve of cauda equina were different in the 13 patients, and the results of clinical physical examination and urodynamic test were also different.② The comparison of the results of clinical neurological examination and urodynamic test showed that the obtained judgements about the neurological injured sites were generally coincident. CONCLUSION： Urodynamic test can be used as a reference indicator for the judgement of spinal injured site in clinical application.
出处
《中国临床康复》
CSCD
北大核心
2005年第33期34-35,共2页
Chinese Journal of Clinical Rehabilitation
