在患有下尿路症状的儿童中,两项尿流量测试之间的协议
Danniele Almeida Neri1, Bruna Afonso Venturini1, Eliakim Massuqueto1
1Center for Childhood Urinary Disorders (CEDIMI), Salvador, Bahia, Brazil.
Journal of pediatric urology
|October 2, 2024
概括
在患有下游泌尿道症状 (LUTS) 的儿童中重复尿道流量计显示了使用ICCS标准的公平协议,但与SPU分类的实质协议. 第二次测试可能不会显著改变诊断或治疗.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 诊断成像 诊断成像 诊断成像
- 下尿道的症状 下尿道的症状
背景情况:
- 尿流量测试是儿童下尿路症状 (LUTS) 的首要非侵入性测试.
- 目前国际儿童节制协会 (ICCS) 的指导方针建议进行两次尿液流量测试以评估LUTS.
- 该研究评估了儿童两项尿液流量测试之间的差异及其临床影响.
研究的目的:
- 在患有LUTS的儿童中,评估两个连续的尿液流量测试之间的差异.
- 评估这些差异对诊断工作和临床结果的影响.
- 为了比较ICCS和SPU分类系统对尿液流量计曲线图案的可靠性.
主要方法:
- 在40名患有LUTS的儿童 (4-17岁) 的前性评估中,使用了两个尿液流量测试和超声波.
- 尿液流量计曲线的分类基于ICCS标准和SPU (分断与光滑) 标准.
- 膀容量的分类 (高,正常,低) 基于空置体积和空置后的残留体积.
主要成果:
- 从第一个到第二个尿液流量测试中观察到非钟形曲线的显著增加.
- 卡帕值表示对ICCS分类的公平协议 (0.349) 和SPU分类的实质性协议 (0.714).
- 在Qmax的时间内发现了不一致,在膀容量分类中具有可变的一致性 (50-68.4%).
结论:
- 与ICCS相比,SPU分类系统显示出更高的可靠性,并可能减少尿液流量测量解释的主观性.
- 尽管有分类差异,但重复尿道流量计似乎并没有显著改变大多数儿科LUTS患者的诊断工作或临床结果.
- 第二次尿液流量测试可能在临床上没有足够的意义,以证明对所有患者的普遍建议.
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