摘要
目的探讨运用家庭尿流检查(home-uroflowmetry,HUF)评估原发性夜间遗尿(primary nocturnal enuresis,PNE)的意义。方法选取2019年12月至2021年3月在郑州大学第一附属医院泌尿外科门诊就诊的41例按照要求完成门诊尿流率检查(office-uroflowmetry,OUF)和48 h HUF的患儿。其中,男23例,年龄为(7.3±2.0)岁,范围为5~13岁,遗尿次数为2~7次/周;女18例,年龄为(7.7±2.3)岁,范围为5~14岁,遗尿次数为1~7次/周。分别记录患儿的排尿量(voided volume,VV)、最大尿流率(maximum urine flow rate,Qmax)、平均尿流率(average urine flow rate,Qave)、排尿时间(voiding time,VT)和尿流曲线进行统计分析。结果OUF和48 h HUF分别记录到41次和568次(包括30次VV<50.0 ml不能纳入统计分析)排尿。48 h HUF记录到的PNE患儿24 h排尿频率、夜间排尿频率、24 h VV和夜间尿量分别为(6.9±1.5)次、(1.1±0.5)次、(1098.1±163.7)ml和(289.6±87.2)ml。48 h HUF与OUF测得的VV为(163.5±33.0)ml比(209.2±61.7)ml,差异具有统计学意义(P<0.001);Qmax为(19.0±3.2)ml/s比(20.6±4.5)ml/s,差异具有统计学意义(P<0.001);Qave为(9.3±1.9)ml/s比(10.3±2.7)ml/s,差异具有统计学意义(P=0.001);VT为(17.9±3.1)s比(20.9±4.6)s,差异具有统计学意义(P<0.001)。Altman-Bland分析显示VV、Qmax、Qave和VT分别仅有13/41、20/41、29/41和16/41的点位于临床可接受界限内,一致性差。对尿流曲线进行分析发现,OUF中Staccato尿流曲线发生率明显高于HUF(19.5%比6.3%)。结论HUF的结果更加符合患儿的生理状态,更加真实可靠,在条件允许情况下优先选取HUF评估PNE患儿膀胱功能。
Objective To explore the significance of home-uroflowmetry(HUF)in assessing primary nocturnal enuresis(PNE).Methods From December 2019 to March 2021,41 children visited our urology clinic and completed office-uroflowmetry(OUF)and 48 h HUF as required.Among them,23 boys had an average age of(7.3±2.0)(5-13)years and the weekly number of enuresis ranged from 2 to 7 times;18 girls had an average age of(7.7±2.3)(5-14)years and the weekly frequency of enuresis ranged from 1 to 7 times.Voided volume(VV),maximal urine flow rate(Qmax),average urine flow rate(Qave),voiding time(VT)and urine flow curve were recorded for statistical analysis.Results Forty-one and 568 voids(including 30 VV<50.0 ml not included for statistical analysis)were recorded by OUF and 48 h HUF respectively.And 24 h urination frequency,nocturnal urination frequency,24 h VV and nocturnal urine volume of PNE children recorded by 48 h HUF were(6.9±1.5)times,(1.1±0.5)times,(1098.1±163.7)ml and(289.6±87.2)ml respectively.VV measured by 48 h HUF and OUF was(163.5±33.0)vs.(209.2±61.7)ml and the difference was statistically significant(P<0.001);Qmax(19.0±3.2)vs.(20.6±4.5)ml/s and the difference was statistically significant(P<0.001);Qave(9.3±1.9)vs.(10.3±2.7)ml/s and the difference was statistically significant(P=0.001);VT(17.9±3.1)vs.(20.9±4.6)s and the difference was statistically significant(P<0.001).Altman-Bland analysis revealed that only 13/41,20/41,29/41 and 16/41 points for VV,Qmax,Qave and VT were all within clinically acceptable limits with a poor agreement.Analysis of urine flow curves revealed that the incidence of Staccato urine flow curve was significantly higher in OUF than in HUF(19.5%vs.6.3%).Conclusion The results of HUF correspond more to the physiological status of children.More real and reliable,HUF is preferentially selected for assessing bladder function in PNE children.
作者
蒲青崧
李琦
杨兴欢
单帅帅
王一鹤
刘二鹏
吕磊
文一博
文建国
Pu Qingsong;Li Qi;Yang Xinghuan;Shan Shuaishuai;Wang Yihe;Liu Erpeng;Lyu Lei;Wen Yibo;Wen Jianguo(Henan Joint International Laboratory of Pediatric Urodynamic,Center of Pediatric Urodynamic,First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)
出处
《中华小儿外科杂志》
CSCD
北大核心
2022年第4期354-358,共5页
Chinese Journal of Pediatric Surgery
基金
国家自然科学基金联合重点项目(U1904208)。
