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題名 | Videourodynamic Findings in Parkinson's Disease=巴金森氏症之錄影尿動力學表現 |
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作者 | 王世農; 郭漢崇; | 書刊名 | 臺灣泌尿科醫學會雜誌 |
卷期 | 18:1 2007.03[民96.03] |
頁次 | 頁23-26+43 |
分類號 | 415.8 |
關鍵詞 | 巴金森氏症; 尿道外括約肌動作遲緩; 錄影尿動力學表現; Parkinson's disease; Sphincter bradykinesia; Videourodynamics; |
語文 | 英文(English) |
中文摘要 | 研究目的:評估巴金森氏症病人之錄影尿動力學表現。 材料與方法:共36位具有排尿障礙之巴金森氏症病人(男性24位,女性12位,平均年齡72歲),由神經內科醫師轉介,接受錄影尿動力學檢查。 結果:有26位病人(佔72.2%)具有刺激性排尿症狀。有31位病人(佔86%)表現出神經性膀胱逼尿肌活動過強,其中有14位病人(佔45.1%)之尿道外括約肌協調良好,10位病人(佔32.31%)為假性協調不良,4位(佔12.91%)為尿道外括約肌放鬆不良,3位病人(佔9.61%)為骨盆底肌放鬆不良。而在比較排尿時肌電圖活陸增強與協調這兩組,其餘尿量及最大尿流速之逼尿肌壓力數值呈現出有意義的統計差異(P<0.05)。 結論:在本研究中,刺激陸排尿症狀與神經性膀胱逼尿肌活動過強是最主要的臨床症狀與錄影尿動力學表現。而在肌電圖活性增強組別中,表現出較高之餘尿量和較低之最大尿流速逼尿肌壓力,可能歸因於尿道阻力升高及可能的尿道膀胱反射。我們需要更嚴謹的標準,排除任何會影響結果的疾病或因子,以找出巴金森氏症正確之錄影尿動力學表現。 |
英文摘要 | OBJECTIVES: This retrospective study was conducted to evaluate the findings of a videourodynamic study in patients with Parkinson's disease and voiding dysfunction. MATERIALS and METHODS: In total, 36 parkinsonian patients (24 men and 12 women) with Parkinson's disease and symptomatic voiding dysfunction underwent videourodynamic studies. The results of the videourodynamic studies were analyzed to further investigate the underlying pathophysiology of their bladder and urethral dysfunctions. RESULTS: Irritative voiding symptoms were found in 26 patients (72.2%). Detrusor overactivity was found in 31 patients (86%), among which 14 patients (45.1%) demonstrated appropriate sphincter relaxation during voiding, while 10 (32.3%) had pseudodyssynergia, 4 (12.9%) had poor relaxation of external urethral sphincter, and 3 (9.6%) showed poor relaxation of the pelvic floor muscle. There were significant differences in the postvoid residual (PVR) and detrusor pressure at maximum flow (Pdet.Qmax) between the groups with hyperactive and coordinated EMG activity during voiding. CONCLUSIONS: Irritative symptoms and detrusor overactivity were the main clinical and urodynamic findings in patients with Parkinson's disease and voiding. dysfunction. Over half of these patients with Parkinson's disease had a hyperactive urethral sphincter and a large PVR. |
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