摘要目的 探讨腰椎间盘突出所致慢性马尾神经损伤的尿动力学特点.方法 对67例男性腰椎间盘突出患者的尿动力学检查结果 进行回顾性分析,均排除下尿路梗阻,并根据逼尿肌功能分为逼尿肌收缩功能正常组(A组)、逼尿肌收缩功能减退组(B组)和逼尿肌无反射组(C组).比较各组间的临床资料和尿动力学检查结果 .结果 3组间在最大逼尿肌压力、最大尿流时逼尿肌压力、最大尿流率、残余尿量均有显著差异.膀胱初始感觉和最大容量在A组与C组,B组和C组之间有显著差异,但在A组和B组之间无显著差异.3组间在年龄、发病时间和膀胱顺应性无显著差异.结论 尿动力学检查可为判断慢性马尾神经损伤的程度提供依据,逼尿肌无反射及膀胱感觉减退表示马尾神经损伤严重.最大尿流率与残余尿量有助于马尾神经损伤的早期诊断.

abstractsObjective To evaluate the urodynamic characteristics of the chrenic impairment of cauda equina caused by lumbar disk bemiation. Methods Clinical data and urodynamic parameters of 67 male patients with lumbar disk berniation were retrospectively analyzed. Lower urinary obstraction was excluded from the cohort using the Lin-PURR analysis. Patients were divided into group A (normal detrusor function), group B (detrusor underactivity) and group C (detrusor areflexia) according to the detrusor contraction function analyzed in Lin-PURR. Clinical data and uredynamic parameters were analyzed statistically between these groups. Results The category of the detrusor contraction function had a significant effect on the urodynamic parameters. There were significant differences in the maximum flow rate (Qmax), maximum pressure (Pmax), pressure at the maximum flow (Pdet Qmax) and post-voiding residual urine (PVR) among group A, B and C. There were significant differences in the first sensation volumn of the bladder and the maximum cystometric capacity between group A and C, B and C, but no significance was found between group A and B. There was no significant difference in age, disease duration, and compliance of the bladder among 3 groups. Conclusions Urodynamic study is important in exploring the severity of the chronic impairment of cauda equina caused by lumbar disk herniation. Detrusor areflexia and loss of bladder sensory indicate more severe degree of impairment of the cauda equine. Qmax and PVR are helpful in early diagnosis of the chronic impairment of eauda equina.