女性尿道中静态尿道压力分布特点的研究

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目的:探讨在女性尿道不同部位和不同方向上静态尿道压力图(RUPP)压力的分布特点。方法:本研究共包括因各种原因需做尿动力学检查的成年女性患者55例,年龄(41±11)岁,其中尿流动力学检查无异常者8例,压力性尿失禁19例,其他诊断(包括OAB、膀胱收缩无力等)28例。采用恒压恒速灌注法测压,将测压孔分别朝向尿道前壁(12点)、后壁(6点)、左侧壁(3点)及右侧壁(9点)四个方向描记RUPP,采用配伍区组方差分析进行统计学分析。结果:前壁的最大尿道闭合压(MUCP)最高(P<0.01),后壁的MUCP最低(P<0.001),左右两侧MUCP无明显差异(P=0.571);前壁的功能尿道长度(FUL)最短(P<0.01),后壁的FUL最长(P<0.001),左右两侧FUL无统计学差异(P=0.717);RUPP曲线均呈抛物线形,高压区和MUCP的最大值位于尿道中段或中远段交界处。结论:本研究结果显示,静态尿道压力图在女性尿道压力分布上,前后壁方向上具有显著的方向性变异,而左右两侧具有对称性和一致性。尿道压力图的压力分布特点与女性尿道壁的组织结构和尿道腔的形态密切相关。 Objective: To investigate the distribution of pressure on the static urethral pressure (RUPP) in different parts of the female urethra and in different directions. METHODS: A total of 55 adult female patients undergoing urodynamic tests for various reasons were included in this study, aged (41 ± 11) years, of whom 8 had no abnormal urine flow test, 19 had stress urinary incontinence, and 19 had other urinary incontinence Diagnosis (including OAB, bladder weakness, etc.) 28 cases. The constant pressure perfusion method was used to measure the pressure, and the pressure-measuring holes were traced in four directions of anterior urethral wall (12 o’clock), posterior wall (6 o’clock), left wall (3 o’clock) and right wall (9 o’clock) RUPP, statistical analysis of variance analysis of compatibility zone group. RESULTS: The maximum urethral closure pressure (MUCP) in the anterior wall was the highest (P <0.01), the posterior wall was the lowest (P <0.001) and there was no significant difference in MUCP between the left and right sides (P = 0.571) (P <0.001). There was no significant difference in FUL between the left and right sides (P = 0.717). The RUPP curve showed a parabola shape with the maximum in the high pressure area and MUCP Urethral middle or distal section of the junction. CONCLUSIONS: The results of this study show that the static urethral pressure map has significant directional variability in the urethral pressure distribution of the female and the posterior-posterior wall, with symmetry and consistency on the left and right sides. The pressure distribution of the urethral pressure map is closely related to the structure of the urethral wall and the shape of the urethral cavity.
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