北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (4): 544-547.

• 论著 • 上一篇    下一篇

脊髓损伤患者上尿路功能损害的相关因素分析

靖华芳,廖利民△,付光,吴娟,鞠彦合,陈国庆   

  1. (中国康复研究中心北京博爱医院泌尿外科,首都医科大学泌尿外科学系, 北京100068)
  • 出版日期:2014-08-18 发布日期:2014-08-18

Analysis for related factors of upper urinary tract deterioration in patients with spinal cord injury

JING Hua-fang,LIAO Li-min△, FU Guang,WU Juan,JU Yan-he,CHEN Guo-qing   

  1. (Department of Urology,China Rehabilitation Research Center Beijing Bo Ai Hospital; Department of Urology, Capital Medical University, Beijing 100068,China)
  • Online:2014-08-18 Published:2014-08-18

摘要: 目的:探讨脊髓损伤患者上尿路功能损害的相关因素。方法:回顾性分析2002年1月至2009年12月期间于中国康复研究中心住院的脊髓损伤患者病历记录,根据诊断标准分为上尿路功能损害组和无上尿路功能损害组,比较两组之间人口学资料(性别、年龄)、脊髓损伤资料(损伤原因、损伤节段、损伤程度)、一般泌尿系统情况(膀胱管理方式、尿常规、尿培养、症状性泌尿系感染、B超、血肌酐)、影像尿动力学资料(膀胱顺应性、 膀胱稳定性、膀胱感觉、逼尿肌括约肌协同性、 逼尿肌漏尿点压力、最大膀胱测压容积、相对安全膀胱容量、 最大尿流率、最大尿道闭合压)等指标之间的差异,进行多因素非条件Logistic回归模型分析,筛选出脊髓损伤患者上尿路损害的危险因素。结果:上尿路功能损害组与无上尿路功能损害组比较,两组患者在脊髓损伤节段(χ2=8.840, P=0.031)、膀胱管理方式(χ2=11.362, P=0.045)、尿常规(χ2=17.983, P=0.000)、症状性泌尿系感染(χ2=64.472, P=0.000)、膀胱顺应性(χ2=6.531, P=0.011)、膀胱感觉(χ2=11.505, P=0.009)、最大膀胱测压容积(t =2.209, P=0.043)、逼尿肌括约肌协同失调(χ2=4.247, P=0.039)等方面差异有统计学意义。多因素非条件Logistic回归分析结果显示:膀胱管理方式(OR=1.114,P=0.006)、症状性泌尿系感染(OR=1.018,P=0.000)、膀胱顺应性(OR=1.588,P=0.040)、逼尿肌括约肌协同失调(OR=1.023,P=0.034)等指标是影响脊髓损伤患者上尿路功能的关键因素。结论:症状性泌尿系感染、膀胱低顺应性、逼尿肌括约肌协同失调及不合理的膀胱管理方式等是脊髓损伤患者上尿路功能损害的危险因素。

关键词: 脊髓损伤, 泌尿道, 排尿障碍, 危险因素

Abstract: Objective:To evaluate the related factors of upper urinary tract deterioration in spinal cord injured patients. Methods: Medical records of spinal cord injured patients from Jan.2002 to Sep.2009 were retrospectively reviewed. All the patients were divided into the upper urinary tract deterioration group and non-deterioration group according to the diagnostic criteria. Indexes such as demographic characteristic (gender, age), spinal cord injury information (cause, level, completeness), statuses of urinary tract system (bladder management, urine routine, urine culture, ultrasound, serum creatinine, fever caused by urinary tract infection) and urodynamics information(bladder compliance, bladder stability, bladder sensation, detrusor sphincter dyssynergia, detrusor leak point pressure, maximum cystometric capacity, relative safe bladder capacity, maximum flow rate, maximum urethra closure pressure) were compared between the two groups.Then Logistic regression analysis were performed.Results: There was significantly difference between the two groups in spinal cord injury level(χ2=8.840, P=0.031),bladder management(χ2=11.362, P=0.045),urinary rutine(χ2=17.983, P=0.000), fever caused by urinary tract infection(χ2=64.472, P=0.000), bladder compliance(χ2=6.531, P=0.011), bladder sensation(χ2=11.505, P=0.009), maximum cystometric capacity(t=2.209,P=0.043), and detrusor-sphincter dyssynergia(χ2=4.247, P=0.039). The multiplefactor non-conditional Logistic regression analysis showed that bladder management (OR=1.114,P=0.006), fever caused by urinary tract infection(OR=1.018,P=0.000), bladder compliance(OR=1.588,P=0.040) and detrusor-sphincter dyssynergia(OR=1.023,P=0.034) were the key factors of upper urinary tract deterioration in spinal cord injured patients.Conclusion: Urinary tract infection, lower bladder compliance, detrusor-sphincter dyssynergia and unreasonable bladder management are the risk factors of upper urinary tract deterioration in spinal cord injured patients.

Key words: Spinal cord injuries, Urinary tract, Urination disorders, Risk factors

[1] 颜野,李小龙,夏海缀,朱学华,张羽婷,张帆,刘可,刘承,马潞林. 前列腺癌根治术后远期膀胱过度活动症的危险因素[J]. 北京大学学报(医学版), 2024, 56(4): 589-593.
[2] 陈延,李况蒙,洪锴,张树栋,程建星,郑仲杰,唐文豪,赵连明,张海涛,姜辉,林浩成. 阴茎海绵体注射试验对阴茎血管功能影响的回顾性研究[J]. 北京大学学报(医学版), 2024, 56(4): 680-686.
[3] 庞博,郭桐君,陈曦,郭华棋,石嘉章,陈娟,王欣梅,李耀妍,单安琪,余恒意,黄婧,汤乃军,王艳,郭新彪,李国星,吴少伟. 天津与上海35岁以上人群氮氧化物个体暴露水平及其影响因素[J]. 北京大学学报(医学版), 2024, 56(4): 700-707.
[4] 和静,房中则,杨颖,刘静,马文瑶,霍勇,高炜,武阳丰,谢高强. 血浆中脂质代谢分子与颈动脉粥样硬化斑块、传统心血管危险因素及膳食因素的关系[J]. 北京大学学报(医学版), 2024, 56(4): 722-728.
[5] 蔡珊,张依航,陈子玥,刘云飞,党佳佳,师嫡,李佳欣,黄天彧,马军,宋逸. 北京市中小学生身体活动时间现状及影响因素的路径[J]. 北京大学学报(医学版), 2024, 56(3): 403-410.
[6] 张祖洪,陈天娇,马军. 中小学生青春发动时相与心血管代谢危险因素的相关性[J]. 北京大学学报(医学版), 2024, 56(3): 418-423.
[7] 林郁婷,王华丽,田宇,巩俐彤,常春. 北京市老年人认知功能的影响因素[J]. 北京大学学报(医学版), 2024, 56(3): 456-461.
[8] 朱金荣,赵亚娜,黄巍,赵微微,王悦,王松,苏春燕. 感染新型冠状病毒的血液透析患者的临床特征[J]. 北京大学学报(医学版), 2024, 56(2): 267-272.
[9] 赖展鸿,李嘉辰,贠泽霖,张永刚,张昊,邢晓燕,邵苗,金月波,王乃迪,李依敏,李玉慧,栗占国. 特发性炎性肌病完全临床应答相关因素的单中心真实世界研究[J]. 北京大学学报(医学版), 2024, 56(2): 284-292.
[10] 司筱芊,赵秀娟,朱凤雪,王天兵. 创伤出血性休克后急性呼吸窘迫综合征的危险因素[J]. 北京大学学报(医学版), 2024, 56(2): 307-312.
[11] 李洋洋,侯林,马紫君,黄山雅美,刘捷,曾超美,秦炯. 孕期因素与婴儿牛奶蛋白过敏的关系[J]. 北京大学学报(医学版), 2024, 56(1): 144-149.
[12] 刘晓强,周寅. 牙种植同期植骨术围术期高血压的相关危险因素[J]. 北京大学学报(医学版), 2024, 56(1): 93-98.
[13] 罗靓,李云,王红彦,相晓红,赵静,孙峰,张晓盈,贾汝琳,李春. 抗内皮细胞抗体检测在早期流产中的预测价值[J]. 北京大学学报(医学版), 2023, 55(6): 1039-1044.
[14] 游芳凝,罗靓,刘香君,张学武,李春. 未分化结缔组织病患者的妊娠结局、疾病演变及其影响因素[J]. 北京大学学报(医学版), 2023, 55(6): 1045-1052.
[15] 李宇菲,闫亚妮,靳家扬,李春,裴秋艳. 合并胎儿心脏病变的抗SSA抗体阳性孕妇的临床及实验室特征[J]. 北京大学学报(医学版), 2023, 55(6): 1053-1057.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!