目的: 开发尿流率视觉量表(visual uroflow scale, VUS),分析量表评分与自由尿流率检查指标的相关性,应用VUS评估排尿功能,提高临床工作效率。方法: 招募2016年3月至2017年3月因下尿路症状(lower urinary tract symptoms, LUTS)就诊于北京大学人民医院泌尿外科的男性患者,进行自由尿流率检测前,患者先进行尿流率视觉量表评分。通过自由尿流率检测,获取最大尿流率、平均尿流率、排尿量等数据信息,并分析其与VUS的相关性。收集124例患者信息,其中53例符合纳入标准。采用Spearman相关性分析对VUS和自由尿流率变量以及患者年龄进行分析。结果: 大多数患者能在第一时间选择最符合自己的图,通过Spearman相关性分析发现,排尿时间与VUS呈正相关(相关系数0.62, P<0.05)。选择第3、第4幅图的患者往往排尿时间更长,提示更严重的LUTS。尿流时间与VUS呈正相关(相关系数0.61,P<0.05),当患者选择更高的VUS分数时,意味着不管尿等待时间多长,这部分患者会花更长的时间来排尿。最大尿流率和平均尿流率均与VUS呈负相关(相关系数为-0.54和-0.62,P<0.05), 提示VUS可以较准确地反映最大尿流率和平均尿流率水平。VUS与年龄呈正相关,反映排尿功能随年龄增长下降。结论: VUS能帮助临床医生初步判断患者排尿功能,患者在接受手术或药物治疗前先进行VUS评估,治疗后再进行评估,所得的量化数据可用于评估治疗效果。考虑到VUS方便、省时、易懂, VUS可能非常适合用于随访。

Objective: To develop the visual uroflow scale (VUS), analyze the relationship of VUS score and index of free uroflowmetry, assess urination function preliminarily and improve the work efficiency in the clinic. Methods: Male lower urinary tract symptoms (LUTS) patients, who attended the Department of Urology in Peking University People’s Hospital from March 2016 to March 2017, were assessed for their urination function according to the Visual Uroflow Scale without help from clinicians before undertaking a free uroflowmetry test. And afterwards, a free uroflowmetry was undertaken, and variables including maximal flow rate (Qmax), the average flow rate (Qave) and voiding volume (VV) was obtained. During the study, 124 cases were collected and 53 cases met the inclusion and exclusion criteria and were included in the study cohort. The Spearman correlation analysis was used for analyzing the correlation of VUS scores with free uroflowmetry variables and age. The validity of VUS was evaluated. Results: Most of the patients could choose the very figure matched with self-condition by first instinct without any help from the clinician. The data were analyzed by Spearman correlation analysis. In the present study, voiding time was positively correlated with the VUS score (correlation coefficient, 0.62, P<0.05). In the present cohort, the patients chose the third and fourth figures to take longer time to urinate, implying worse LUTS situation. Flow time and VUS scores were positively correlated (correlation coefficient, 0.61, P<0.05). The patients with higher VUS scores would spend more time on urinate, no matter how long urinary hesitation was. Both Qmax and Qave were negatively correlated with the VUS score (correlation coefficient -0.54, -0.62, P<0.05). The study illustrated that the VUS score suggested that the Qmax basically and further reflected the urination function. And its relationship to age revealed the decreased urination function of aging male, which had reached a consensus. Conclusion: Development of VUS has helped the clinician assess the urination function preliminarily at the first time. Patients are assessed for a VUS score before getting surgery or receiving the drug for treatment, and can be re-assessed after. The VUS score can provide an objective quantitative basis to evaluate the treatment efficacy. In addition, considering that it is convenient, timesaving and easy to understand, the VUS is available for follow-up.