儿童反射亢进型神经原性尿失禁的手术治疗及术后排尿训练

背景：脊柱裂引起的脊髓发育不良是儿童最常见的神经系统发育畸形之一，由此而引起的神经原性尿失禁可严重影响患儿的生活质量。目的：观察反射亢进型神经源性尿失禁的手术治疗及术后排尿训练效果。设计：前后对照，随访观察。单位：郑州大学第一附属医院的小儿外科。对象：于1992-01／2000—10治疗81例反射亢进型神经原性尿失禁患儿，男54例，女27例，年龄4—14岁，术前检查均证实盆底肌松弛，膀胱容量小。所有患均为神经原性尿失禁患并经尿流动力学结果证实为反射亢进型神经原性膀胱。方法：对81例患采用双侧髂腰肌加强盆底肌，回肠去黏膜带血管蒂浆肌层补片的基础上，行膀胱扩大术进行治疗，其中5例行锥状肌膀胱颈悬吊。术后3周，伤口愈合良好后，进行康复协调训练。随访患术后尿失禁症状改善情况。结果：81例术后2周拔除尿管后，40例患儿尿前有尿意，尿流呈线状，两次排尿间隔在60min以上，膀胱最大容量、残余尿量、膀胱压力接近正常或正常，视为明显改善。23例患儿有尿意，尿流呈线状，两次排尿间隔时间在40min左右，膀胱最大容量，残余尿量较术前减少，膀胱压力增大，视为改善。18例无效，经过正规排尿训练后较前有改善。对9例进行膀胱尿道测压，膀胱压平均1．2kPa，尿道压平均1．15kPa，剩余尿30-50mL，最大容量300—600mL。81例患儿有63例得到严格随访，完整随访期6个月，其余部分随访资料不完整。63例被随访中56例控尿明显改善，5例改善，2例无效，总有效率达到97％。结论：双侧髂腰肌加强盆底肌，回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌基础上行膀胱扩大术是治疗小儿反射亢进型神经原性尿失禁的较好方法，配合术后排尿反射及控制训练对治疗效果影响明显。     

回肠浆肌层补片膀胱扩大术治疗反射亢进型神经原性尿失禁的疗效随访

背景神经原性尿失禁手术治疗方法多样,疗效不一,探讨手术治疗神经原性尿失禁的效果,以求证其有效性.目的评价去粘膜回肠浆肌层补片膀胱扩大术治疗反射亢进型神经原性尿失禁疗效,为改良手术提出建议.设计以患者为研究对象的回顾性病例分析.单位一所大学医院的小儿外科.对象对郑州大学第一附属医院小儿外科自1998-04/2004-01手术治疗的68例神经原性尿失禁患者进行随访,所有患者术前均确诊为神经原性尿失禁,随访资料完整者共38例.方法对38例反射亢进型神经原性膀胱患者随访4～69个月,平均17.2个月.患者年龄4～17岁,38例患者行去粘膜回肠浆肌层补片膀胱扩大术,34例盆底肌松弛者同时行双侧髂腰肌盆底加强术.主要观察指标观察手术前后症状、膀胱顺应性、最大膀胱容量和相对安全膀胱容量.结果30例(79%)尿失禁症状改善(控尿时间＞1 h);尿动力学检查示所有行回肠去浆肌层膀胱扩大术患者术后均为腹压排尿,尿流动力学检查均未发现在排尿期有主动的逼尿肌收缩;术后顺应性增加(27.43±24.78)mL/kPa(P＜0.01),最大膀胱容量较术前增加(122.18±79.99)mL(P＜0.01),相对安全膀胱容量较术前增加(98.63±86.78)mL(P＜0.01).未发现有上尿路功能受损加重情况.结论去粘膜回肠浆肌层补片膀胱扩大术可保护上尿路功能,是有效治疗神经原性膀胱的一种方法.     

回肠浆肌层补片膀胱扩大术治疗反射亢进型神经原性尿失禁的疗效随访

背景:神经原性尿失禁手术治疗方法多样,疗效不一,探讨手术治疗神经原性尿失禁的效果,以求证其有效性.目的:评价去粘膜回肠浆肌层补片膀胱扩大术治疗反射亢进型神经原性尿失禁疗效,为改良手术提出建议.设计:以患者为研究对象的回顾性病例分析.单位:一所大学医院的小儿外科.对象:对郑州大学第一附属医院小儿外科自1998-04/2004-01手术治疗的68例神经原性尿失禁患者进行随访,所有患者术前均确诊为神经原性尿失禁,随访资料完整者共38例.方法:对38例反射亢进型神经原性膀胱患者随访4～69个月,平均17.2个月.患者年龄4～17岁,38例患者行去粘膜回肠浆肌层补片膀胱扩大术,34例盆底肌松弛者同时行双侧髂腰肌盆底加强术.主要观察指标:观察手术前后症状、膀胱顺应性、最大膀胱容量和相对安全膀胱容量.结果:30例(79%)尿失禁症状改善(控尿时间＞1 h);尿动力学检查示:所有行回肠去浆肌层膀胱扩大术患者术后均为腹压排尿,尿流动力学检查均未发现在排尿期有主动的逼尿肌收缩;术后顺应性增加(27.43&;#177;24.78)mL/kPa(P＜0.01),最大膀胱容量较术前增加(122.18&;#177;79.99)mL(P＜0.01),相对安全膀胱容量较术前增加(98.63&;#177;86.78)mL(P＜0.01).未发现有上尿路功能受损加重情况.结论:去粘膜回肠浆肌层补片膀胱扩大术可保护上尿路功能,是有效治疗神经原性膀胱的一种方法.     

小儿骶前畸胎瘤术后尿失禁的治疗与康复

目的探讨小儿骶前畸胎瘤术后尿失禁的排尿控制方法。方法3～14岁患儿12例,均为骶前畸胎瘤切除术后,表现为排尿异常,逼尿肌无反射,尿道压较膀胱压高。全部患儿均采用双侧髂腰肌加强盆底肌,回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌。行膀胱扩大或包裹术治疗。术后3周开始进行长期康复功能训练。结果随访6个月～6年,尿控制明显改善10例。另外2例经过训练也有所改善。膀胱最大容量300mL,膀胱压平均1.66kPa,尿道压平均3.83kPa。结论双侧髂腰肌加强盆底肌,回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌是治疗小儿骶前畸胎瘤术后尿失禁的一种较好方法,术后进行康复协调功能训练也是治疗的重要措施。     

小儿骶前畸胎瘤术后尿失禁的治疗与康复

目的探讨小儿骶前畸胎瘤术后尿失禁的排尿控制方法。方法3-14岁患儿12例，均为骶前畸胎瘤切除术后，表现为排尿异常，逼尿肌无反射，尿道压较膀胱压高。全部患儿均采用双侧髂腰肌加强盆底肌，回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌。行膀胱扩大或包裹术治疗。术后3周开始进行长期康复功能训练。结果随访6个月一6年，尿控制明显改善lO例。另外2例经过训练也有所改善。膀胱最大容量300mL，膀胱压平均1．66kPa，尿道压平均3．83kPa。结论双侧髂腰肌加强盆底肌，回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌是治疗小儿骶前畸胎瘤术后尿失禁的一种较好方法，术后进行康复协调功能训练也是治疗的重要措施。     

反射亢进型神经源性尿失禁膀胱逼尿肌中氮能神经及一氧化氮的变化对膀胱功能的影响

目的:研究反射亢进型神经源性尿失禁膀胱逼尿肌中氮能神经分布和一氧化氮(NO)含量的变化,探讨其对膀胱功能的影响。方法:采用免疫组化法测定反射亢进型神经源性尿失禁患儿和膀胱功能正常小儿膀胱顶部逼尿肌中一氧化氮合酶(NOS)阳性神经;利用硝酸还原法测定逼尿肌中NO的含量变化。临床对于81例4～14岁反射亢进型神经源性尿失禁患儿,采用双侧髂腰肌加强盆底肌、回肠去黏膜带血管蒂浆肌层补片的基础上,行膀胱扩大术膀胱或包裹术进行治疗。结果:反射亢进型神经源性尿失禁患儿膀胱逼尿肌中NOS阳性神经数及NO含量明显低于正常对照组(P<0.05)。对于81例患者随访6个月～7年,尿失禁症状明显改善63例、术后经严格的训练有改善的18例。但其中有两例效果稍差。结论:反射亢进型神经源性尿失禁患儿膀胱逼尿肌中氮能神经的去神经及NO含量的减少,可能是造成逼尿肌反射亢进的一个因素,采用双侧髂腰肌加强盆底肌、回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌基础上行膀胱扩大或包裹术是治疗小儿反射亢进型神经源尿失禁的一种较好的术式。     

反射亢进型神经源性尿失禁膀胱逼尿肌中氮能神经及一氧化氮的变化对膀胱功能的影响

目的：研究反射亢进型神经源性尿失禁膀胱逼尿肌中氮能神经分布和一氧化氮(NO)含量的变化，探讨其对膀胱功能的影响。方法：采用免疫组化法测定反射亢进型神经源性尿失禁患儿和膀胱功能正常小儿膀胱顶部逼尿肌中一氧化氮合酶(NOS)阳性神经；利用硝酸还原法测定逼尿肌中NO的含量变化。临床对于81例4～14岁反射亢进型神经源性尿失禁患儿，采用双侧髂腰肌加强盆底肌、回肠去黏膜带血管蒂浆肌层补片的基础上，行膀胱扩大术膀胱或包裹术进行治疗。结果：反射亢进型神经源性尿失禁患儿膀胱逼尿肌中NOS阳性神经数及NO含量明显低于正常对照组(P&lt;O．05)。对于81例患者随访6个月～7年，尿失禁症状明显改善63例、术后经严格的训练有改善的18例。但其中有两例效果稍差。结论：反射亢进型神经源性尿失禁患儿膀胱逼尿肌中氮能神经的去神经及NO含量的减少，可能是造成逼尿肌反射亢进的一个因素，采用双侧髂腰肌加强盆底肌、回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌基础上行膀胱扩大或包裹术是治疗小儿反射亢进型神经源尿失禁的一种较好的术式。     

小儿神经源性尿失禁的外科治疗与康复训练

目的探讨小儿神经源性尿失禁的治疗方法及康复训练方法。方法对4～14岁206例神经源性尿失禁患儿,在改良的髂腰肌加强盆底肌、回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌的基础上行膀胱扩大术和膀胱包裹术进行治疗。术后3周开始进行长期康复功能训练。结果术后随访半年至7年,尿控制明显改善183例,术后经过训练又有改善23例。结论此方法是治疗小儿神经源性尿失禁的较好方法,康复功能训练也是治疗的重要措施。     

小儿神经源性尿失禁的外科治疗与康复训练

目的 探讨小儿神经源性尿失禁的治疗方法及康复训练方法。方法 对4－14岁206例神经源性尿失禁患儿，在改良的髂腰肌加强盆底肌，回肠去黏膜带血管蒂浆肌层补片加强膀胱逼尿肌的基础上行膀胱扩大和膀胱包裹术进行治疗。术后3周开始进行长期康复功能。训练。结果 术后随访半年至7年，尿控制明显改善183例，术后经过训练又有改善23例。结论 此方法是治疗小儿神经源性尿失禁的较好方法，康复功能训练也是治疗的重要措施。     

盆底肌系列训练法对压力性尿失禁患者的干预效果评价

目的 探讨盆底肌系列行为训练法对压力性尿失禁(SUI)的治疗效果.方法随机抽取41例压力性尿失禁患者,对他们开展为期6个月的泌尿系统和盆底肌相关解剖、生理知识讲座,视觉错误图引导式盆底肌训练法,循序渐进式间断排尿训练和尿急训练等.并对训练效果进行评价.结果训练后患者的主观评价有所改善,1 h尿垫试验、3 d漏尿、初始尿意膀胱容量、最大膀胱容量等指标训练前后比较均有显著差异.结论盆底肌系列训练法简便易行,可减轻SUI患者的身心痛苦.     

Urinary incontinence in the man--pathophysiology and diagnosis

About 7-8% of men experience unvoluntary urinary leak. Incidence in patients older than 60 years is 2-3 fold increased. Urge incontinence is the mostly present, less frequent are overflow-incontinence/chronic retention and urinary stress incontinence. In men, prostate and bladder dysfunction as well as neurologic diseases are responsible for urinary incontinence. The baseline diagnostics include micturition protocols, the urologic clinical examination, residual urine determination and laboratory analyses of urine and blood. Extended diagnostics proceed to morphological and infectious etiologies and base on urodynamic evaluation.     

电针膀胱经腧穴联合膀胱治疗仪治疗脊髓损伤后神经源性膀胱的临床疗效观察

目的：探讨电针膀胱经腧穴联合膀胱治疗仪治疗脊髓损伤（SCI）后神经源性膀胱（NB）的临床疗效及其对膀胱功能状态的影响。方法：选取42例SCI后NB患者，随机分为联合组和对照组，每组21例。对照组在基础治疗上采用膀胱治疗仪治疗，联合组在基础治疗上采用电针膀胱经腧穴联合膀胱治疗仪治疗。观察2组患者在治疗方案实施前、后排尿日记的指标：24h排尿次数、24h尿失禁次数、每次排尿量；尿流动力学指标：膀胱充盈逼尿肌压力、最大尿流率、最大尿道闭合压、残余尿量；LUTS评分，比较2组各项指标的变化。结果：治疗后，2组患者24 h 尿失禁次数、24 h排尿次数及尿流动力学观察指标逼尿肌压力、残余尿量分别较治疗方案实施前均减少，联合组减少更明显，排尿日记的观察指标每次排尿量及尿流动力学观察指标最大尿流率、最大尿道闭合压较治疗方案实施前均增大，联合组增大更明显，差异均具有统计学意义(P<0.05)。治疗后2组患者的 LUTS 评分较前均有明显减少(P<0.05)，且联合组更低于对照组(P<0.05)。结论：电针膀胱经腧穴联合膀胱治疗仪治疗SCI后 NB临床疗效较好，明显减少膀胱残余尿量，膀胱功能状态有效改善，生活质量得到提高，具有联合康复应用价值。     

Effect of rehabilitation exercises on urinary function of incontinence after per urethra prostate opertation

Background:Urinay incontience is complication following benign hyperlasia of prostate undergo endoscopic removal.Due to internal imbalance of micturition mechanism mainly,such as incompetence of posterior urethra or unstable detrusor.Urinary incontinence causes not only physiological,psychological disorder,but also family and social problems.Objective:To observe effect of rehabilitation exercises on urinary function of urinary incontinence patients following per urethrakprostate operation.Unit:South-west Hospital,Third Military Medical University.Subjects:1525 male patients,aged 62-95 years old.Perurethra prostate electric technique,prostate holmium laser were done under peridural or general anesthesia.Urinary catheter was removed at 3-5 days after operation.There were 78 cases urinary incontinence after urinary catheter was taken out.After urodynamic study and culture of midstream urine,78 urinary incontinence were divided into:imminent urinary incontinence 48 cases,compression urinary incontinence 26 cases,real urinary incontinence 4 cases.Intervention:(1)To imminent urinary incontinence caused by infection,first strengthening anti-infection treatment,sensitive antibiotic was used.Sitz bath in potassium permanganate warm water patients were encouraged to drink more water and get liquid 1500-2000ml/d in case of no venous inflow,drink water once every 2-3h.Urinary mechanical douche was kept so as to lighten urinary irritation.Water intake should be reduced at night and in winter.(2) To precipitant urinary incontinence caused by unstable bladder.Patients should be guided whten they had urination consciousness,horizontal and genuflex position,deep breathed,relaxed abdominal muscle,constracted pelvic muscle and sphincter of anus,time of urination was delayed as for as possible.After urgent feeling decrease,went to toilet.With improvement of self-controlled ability of urination,went of toilet at fixed time.Patients were warned to tried their best to micturite once each hour.They should micturite at fixed time as far as possible,the time was prolonged to once every 3-4h.According to rehabilitation state of patients later finally biofeedback model was formed.Results: 14 urinary incontinence caused by inflammatory stimulus,remitted after 7-21d,normal micturition recovered after 1 month,9 cases.In 25 cases of urgent urinary incontinence,12 cases could control micturition,after 2 weeks,7 cases could control micturition after 1 month,other 6 cases could control micturition partly.In compression urinary incontinence patients,16 cases couldf control micturition after 1 month.10 Cases kept exercises after discharge,in those 8 cases could control micturition after 2-3 months,2 cases could control micturition at daytime.Two real urinary incontinence patients symptom was improvement.Conclusion: Rehabilitation exercises of urinary incontinence patients after per urethra prostate operation can improve their micturition function effectively.     

基于信息-动机-行为模型的护理干预结合围术期膀胱功能训练对胃肠手术后尿潴留患者尿动力学指标的影响

目的探讨基于信息-动机-行为模型的护理干预结合围术期膀胱功能训练对胃肠手术后尿潴留患者尿动力学指标的影响。方法将100例胃肠手术后急性尿潴留患者根据抽签法随机分为对照组与观察组,各50例。对照组给予常规护理,观察组在对照组基础上给予基于信息-动机-行为模型的护理干预结合围术期膀胱功能训练。比较两组的护理效果。结果观察组的膀胱功能恢复有效率、首次排尿量、残余尿量及恢复自主排尿时间均优于对照组(P<0.05)。干预后,观察组的最大尿流率、最大逼尿肌压力及初尿感膀胱容量均优于对照组,SAS及SDS评分均低于对照组(P<0.05)。结论基于信息-动机-行为模型的护理干预结合围术期膀胱功能训练可有效改善胃肠手术后尿潴留患者膀胱功能,促进尿动力学指标及心理状态改善。     

Bladder wall thickness on ultrasonographic cystourethrography: affecting factors and their implications.

OBJECTIVE: To explore factors affecting bladder wall thickness on ultrasonographic cystourethrography in female patients with lower urinary tract symptoms. METHODS: The records of 492 female patients with lower urinary tract symptoms who had undergone a urodynamic study and ultrasonography of the lower urinary tract and who had normal urinalysis findings, negative urine culture results, or both were identified from our urogynecologic database. These included 248 patients with urodynamic stress incontinence, 38 with detrusor overactivity, 39 with mixed incontinence, 35 with a hypersensitive bladder, 42 with voiding difficulty, and 90 with normal urodynamic findings. RESULTS: Age, resting bladder neck angle, urethral mobility, and maximum urethral closure pressure were significantly associated with bladder wall thickness at the trigone and dome. Bladder wall thickness at the trigone was correlated with that at the dome (P < .0001). Bladder wall thickness at the trigone was positively correlated with pressure transmission ratios in the first and second quarters of the urethra (P < .0001; P = .002, respectively), whereas that at the dome was positively correlated with intravesical pressure at maximum flow and with detrusor opening pressure (P = .027; P = .046, respectively). Age and intravesical pressure at maximum flow were independently associated with bladder wall thickness at the trigone and dome (P = .007; P = .028), respectively. A thickened bladder wall was a common finding in female lower urinary tract symptoms, except in the patients with a hypersensitive bladder. CONCLUSIONS: Demographic, anatomic, and urodynamic factors may affect the bladder wall thickness at the trigone, dome, or both.     

Behaviour modification group-treatment of children with recurrent lower urinary tract infections

It has long been recognized that infrequent micturition and incomplete emptying of the bladder in children represent important factors in the causation of incontinence during the day, and of urinary tract infections (UTI). Behaviour modification is well documented, both as an individual- and a group intervention. The purpose of our study was to develop a programme for group intervention with children, with the aim of improving the children's micturition habits and thereby changing the frequency of wettings, the amount of residual urine, and the UTI frequency. The children responded quickly to the intervention. The amount of residual urine was unaffected, but there are methodological problems in measuring this. There were, however, significant reductions in incontinence and UTI, although there was a tendency to relapse of incontinence over time, probably because of lack of continued follow-up. It is tentatively concluded that the described behavioural intervention seemed effective in improving children's micturition habits, thereby changing the frequency of wettings, and the frequency of urinary tract infections. The treatment seems to be suitable for nursing intervention, either within a hospital setting, or on an outpatient, primary care basis.     

Urinary incontinence in the woman--pathophysiology and diagnosis

Since urinary incontinence is one of the most frequent female health problems and may severely affect a woman's life quality, knowledge about its pathophysiology, evaluation and therapy is very important. Even basic diagnostic tests can determine the type of incontinence (stress or urge urinary incontinence) thus permitting appropriate therapy to be initiated. The patients history, micturition diary, clinical evaluation, perineal ultrasound and urinalysis are important parts of these basic diagnostic tests. The positive stress cough test and the typical symptoms such as urine loss during physical activity point to the diagnosis of stress urinary incontinence. Frequency, nocturia and urgency with or without urine loss as well as more objective criteria such as micturition diaries and urinalysis indicate urge incontinence. Questions to help determine how quality of life is affected by the incontinence symptoms aid in deciding how urgent the treatment is. An urodynamic evaluation together with perineal ultrasound and cystoscopy is performed in patients with complex or recurrent urinary incontinence after surgery or with micturition disorders.     

膀胱尿压测定评定系统在糖尿病神经源性膀胱护理中的应用

目的：观察膀胱尿压测定评定系统在糖尿病神经源性膀胱（ DNB ）护理中的应用效果。方法选择住院治疗的糖尿病神经源性膀胱患者50例,应用膀胱尿压测定评定系统了解膀胱压力容量变化、膀胱安全容量和最大容量、逼尿肌起始活动状态,括约肌状态、逼尿肌/括约肌协同能力,据此制订护理方案并实施,比较干预前后膀胱残余尿量及排尿功能变化。结果本组患者中尿失禁9例,尿潴留40例;膀胱训练后膀胱残余尿量＞200 ml患者从20例降至5例,中重度排尿功能障碍患者从22例降至7例,训练前后比较差异有统计学意义（U值分别为4．73,5．51;P＜0．01）。低顺应性小容量膀胱1例,转外科手术治疗。结论膀胱尿压测定评定系统用于糖尿病神经源性膀胱护理安全可行,可减少膀胱残余尿量,改善排尿功能。     

Dynamic morphological changes in the anterior vaginal wall before and after laparoscopic Burch colposuspension in primary urodynamic stress incontinence.

OBJECTIVE: To evaluate dynamic morphological changes in the anterior vaginal wall in primary urodynamic stress incontinence before and after laparoscopic Burch colposuspension and to explore the related effects on urethral and voiding functions. METHODS: Ultrasound cystourethrography and urodynamic study were performed in 112 patients with primary urodynamic stress incontinence before and 3 months after laparoscopic Burch colposuspension. Ultrasound assessment included measurement of the bladder neck positions at rest and during straining, the bladder wall thickness at the dome and trigone, and observation of the motion of the bladder neck in addition to the development of cystocele on Valsalva maneuver. On ultrasonography, a cystocele was defined as prolapse or descent of the bladder base below the bladder neck at rest, on Valsalva, or both. RESULTS: After laparoscopic Burch colposuspension, ultrasound cystourethrography revealed significant differences in the bladder neck position at rest and during stress (preoperative median 93 degrees vs. postoperative 70 degrees at rest and preoperative 160 degrees vs. postoperative 81 degrees during stress, P < 0.001, respectively) and rotational angle (preoperative median 58 degrees vs. postoperative 10 degrees , P < 0.001). A laparoscopic Burch operation corrected 50% (5/10) of the preoperative cystoceles. However, a residual cystocele developed postoperatively in 29% (30/102) of the women who did not have one previously. Postoperative ultrasonographic and urodynamic studies did not reveal any differences between those women with or without postoperative cystocele except for the residual urine volume, detrusor opening pressure, and straining and rotational angles of the bladder neck (P < 0.001, 0.032, 0.010 and < 0.001, respectively). CONCLUSIONS: Laparoscopic Burch colposuspension may correct a pre-existing cystocele, but in other patients a cystocele may persist or be disclosed. After laparoscopic Burch operation a persistent cystocele is not associated with urethral compression or voiding impairment.     

尿动力学检查对糖尿病患者膀胱功能的评价

目的：探讨尿动力学检查在糖尿病患者膀胱功能障碍诊断的意义。方法：对伴有下尿路症状的糖尿病患者34例，按糖尿病病史分为早期组（〈8a）与进展期组（〉10a），分别进行尿动力学测定，获取膀胱初始容量、最大膀胱容量、最大尿流率、残余尿、逼尿肌压力等参数作相关分析。结果：34例均完成尿动力学测定，尿动力学表现异常占30例（88．2％）；早期组与进展期组相比，最大尿流率明显下降（P〈0．01），初始尿意容量、残余尿、最大膀胱容量明显增高（P〈0．01），逼尿肌收缩力亦下降（P〈0．01）。结论：尿流动力学检查是对DCP进行客观评价的最重要的手段；早期的糖尿病患者予以治疗干预，对预防膀胱功能恶化有重要的意义。