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目的 探讨瓣膜膀胱综合征(VBS)患儿的尿动力学表现及其意义。方法 16 例男性后尿道瓣膜电切术后患儿,年龄平均(3.2±1.8)岁。分为2组,全部患儿均在2岁前行后尿道瓣膜电切术。第一组7例,平均年龄(1.6±0.3)岁,术后至尿动力学检查间隔时间小于1 年。第二组9 例,平均年龄(4.5±1.2)岁,间隔时间大于1年,平均(3.5±1.3)年。对比两组尿动力学结果。结果 第二组最大逼尿肌收缩压(Pdet.max)和膀胱顺应性(BC)分别为(56.2±14.1) cmH2 O和(12.5±7.4)ml/cmH2O,低于第一组Pdet.max(95.1±18.3 ) cmH2 O和BC(52.4±26.9) ml/cmH2 O;第二组残余尿量(PVR)和最大膀胱容量(MBC)分别为(96.6±52.4) ml 和(217.4±61.7) ml,大于第一组PVR(42.8±38.9) ml和MBC(138.1±20.1) ml,差异有统计学意义(P<0.05)。两组分别有4 例和2例有逼尿肌不稳定(DI),Fisher’s精确概率检验两者差异无统计学意义(P>0.05)。在第二组中2例逼尿肌无收缩,有4 例出现较特殊的排尿,表现为逼尿肌收缩波不光滑, 该4 例Pdet.max平均(62.3±9.1) cmH2O,PVR平均(87.5±41.9) ml。结论 VBS膀胱功能异常多发.年龄较大患儿逼尿肌功能较年龄较小患儿差。尿动力学检查能及时发现膀胱功能异常和指导下一步治疗。因此,所有PUV患儿均应行该检查以了解膀胱功能,
Objective To investigate the urodynamic characteristics of children with valvular syndrome (VBS) and its significance. Methods 16 cases of male posterior urethral valve resection in children, mean age (3.2 ± 1.8) years. Divided into two groups, all children were 2 years before the line urethral valve resection. The first group of 7 patients, mean age (1.6 ± 0.3) years of age, postoperative to urodynamic examination interval of less than 1 year. The second group of 9 patients, mean age (4.5 ± 1.2) years old, interval greater than 1 year, mean (3.5 ± 1.3) years. Comparison of two groups of urodynamic results. Results The maximum detrusor systolic pressure (Pdet.max) and bladder compliance (BC) in the second group were (56.2 ± 14.1) cmH 2 O and (12.5 ± 7.4) ml / cmH 2 O, respectively, 95.1 ± 18.3) cmH 2 O and BC (52.4 ± 26.9) ml / cmH 2 O. The PVR and MBC of the second group were (96.6 ± 52.4) ml and (217.4 ± 61.7) ml, Which was significantly higher than that of the first group (42.8 ± 38.9) ml and MBC (138.1 ± 20.1) ml, the difference was statistically significant (P <0.05). There were no detrusor instability (DI) in 4 cases and 2 cases in both groups, Fisher’s exact test showed no significant difference (P> 0.05). In the second group, 2 cases of detrusor no contraction, 4 cases of more special urination, the performance of detrusor contraction wave is not smooth, the 4 cases of Pdet.max (62.3 ± 9.1) cmH2O, PVR average (87.5 ± 41.9) ml. Conclusions Bladder dysfunction is frequent in VBS. Detrusor function in older children is worse than that in younger children. Urodynamics can detect bladder dysfunction and guide the next step in treatment. Therefore, all PUV children should be checked in order to understand the bladder function,