Kết quả áp lực đồ bàng quang ở bệnh nhân nữ có rối loạn đường tiểu dưới=Urodynamics characteristics of female lower urinary tract symptoms

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Phúc Liên Lê, Thị Hồng Oanh Nguyễn, Văn Nghĩa Nguyễn, Cao Tháp Phạm, Lê Chuyên Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.70-77

Bộ sưu tập: Metadata

ID: 242610

Thêm vào giỏ

Đánh giá chức năng bàng quang bằng phép đo áp lực đồ bàng quang ở phụ nữ có triệu chứng đường tiểu dưới, tập trung vào bệnh lý rối loạn đi tiểu. Đối tượng và phương pháp: 64 bệnh nhân nữ có rối loạn đi tiểu đã điều trị nội khoa thất bại. Tuổi, các bệnh lý đi kèm, các thông số niệu động học được thống kê để xác định mối liên quan giữa cảm giác và sự co cơ bàng quang. Kết quả: Áp lực đồ bàng quang bình thường ở 10.9% bệnh nhân (n = 8) và ghi nhận 45.3% bệnh nhân có bệnh lý bàng quang giảm trương lực (DU) (n = 29), 15.6% bệnh nhân bị tăng hoạt cơ detrusor kèm giảm co cơ trong giai đoạn tống xuất (DHIC) (n = 10), 25.9% bệnh nhân có tăng nhạy cảm bàng quang (HSB) (n = 23), 21.9% bệnh nhân có bàng quang tăng hoạt (DO) 21.9% (n = 14), 17.1% bệnh nhân có tăng trương lực cơ vòng niệu đạo (HTRNS) (n=11) và 14.1% bệnh nhân bị bế tắc đường ra bàng quang (BOO) (n = 9). Giảm cảm giác bàng quang và dung tích bàng quang lớn được ghi nhận trong nhóm bàng quang giảm trương lực so với nhóm bế tắc đường ra của bàng quang. Chỉ số co cơ bàng quang và hiệu quả đi tiểu thấp hơn ở nhóm DU so với nhóm BOO. Kết luận: Mặc dù rối loạn đi tiểu ở phụ nữ chiếm tỉ lệ cao nhưng thường không được chú ý đủ. Các bệnh lý này thường dễ bị bỏ sót do triệu chứng lâm sàng không đặc hiệu. Áp lực đồ bằng quang là phép đo cần thiết để chẩn đoán bệnh nhưng chưa được sử dụng rộng rãi trên thực hành lâm sàng ở Việt Nam. Tiêu chuẩn chẩn đoán các rối loạn đường tiểu ở phụ nữ cũng chưa có do đó cần thực hiện nhiều nghiên cứu sâu và rộng hơn trong tương lai.Voiding dysfunction has gained interest due to its high prevalence in the elderly. This study characterized bladder dysfunction in women with lower urinary tract symptoms using urodynamic studies focused on voiding dysfunction. Patients and methods: We studied 64 women which voiding dysfunction in which firstline medical treatment failed. Age, comorbidities, and urodynamic parameters were analyzed to determine the association between bladder sensation and contractility. Results: Urodynamics studies were normal in 10.9% (n = 8) of patients and showed DU in 45.3% (n = 29), detrusor hyperactivity and impaired contractility (DHIC) in 15.6% (n = 10), hypersensitive bladder in 25.9% (n = 23), detrusor overactivity (DO) in 21.9% (n = 14), high tone non-relaxing urethral sphinter (HTRNS) in 17.1% (n=11) and bladder outlet obstruction in 14.1% (n = 9). Decreased bladder sensation and larger cystometric bladder capacity were noted in the DU group compared to the BOO groups. Bladder contractility index and voiding efficiency were lower in the DU compared to the BOO group. Conclusion: Although voiding dysfunctions in women account for a high rate, they are often not given enough attention. These disorders are easily misdiagnosed because clinical symptoms are often nonspecific. Urodynamics is a very essential test to diagnose but has not been widely used in clinical practice in Vietnam. Diagnostic criteria for urinary disorders in women are not yet available, so more extensive and in-depth research and statistics need to be performed in the near future.

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