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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李偉嘉 | 對於膀胱過動症病人施以尿急迫嚴重程度量度可以預測尿路動態檢查下出現逼尿肌過動的表現 | 2013/5/30 下午 08:03:48 | 0 |
| 原 文 | 題 目 | Urgency Severity Scale Could Predict Urodynamic Detrusor Overactivity in Patients With Overactive Bladder Syndrome |
| 作 者 | 鍾旭東，廖俊厚，陳奕舟、郭漢崇 | |
| 出 處 | Neurourology and Urodynamics 30: 1300-1304, 2011 | |
| 出版日期 | 2011, Sept. | |
| 評 論 |
此篇是亞東醫院鍾旭東主任與慈濟郭漢崇教授的又ㄧ重要著作。本文闡述，膀胱過動症患者其尿急嚴重程度與尿路動態學上逼尿肌過動表現的關連性。眾所週知，膀胱過動症對於病患最重要的影響在於生活品質與社交能力的嚴重干擾。其中尤以OAB wet，即會產生尿失禁的膀胱過動症對於患者生活影響的嚴重程度最高。而在ㄧ般膀胱過動症的研究中，學者們常常發表膀胱過動症與尿路動態檢查的結果不能相互匹配，造成醫師治療患者的困擾。 事實上，醫師要有好的量度工具使之與病患臨床表現匹配，如此醫師對於病患的診斷、治療、與後續評估將有莫大的作用。很多臨床工作者，常常以為只有進行臨床研究的醫師，才需要使用問卷。其實在功能性泌尿學(functional urology)的領域，在門診面對病人時，各種評估量表或問卷如(bladder diary、AUA-SI、IIEF-5、)，已經是醫師診斷治療時不可或缺的工具。有志於本門研習者，平日應熟習各項問卷的問法與臨床使用。以達客觀評估、診斷、治療病患 本文的研究，鍾主任說明了尿急迫嚴重程度量度，可以反應膀胱過動症病人其尿路動態學檢查中，出現逼尿肌過動的比率。這一研究合理的說明膀胱過動症研究中，膀胱過動症、尿急迫、急迫性尿失禁與逼尿肌過動的相關性。同時澄清了在從前的定義中，醫學界對於sensory urgency 與motor urgency 的觀察。在此恭喜鍾主任的學術成就，也恭喜鍾主任於近日獲得台大臨床醫學研究所的博士學位。 |
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| abstract |
Aims: To evaluate the correlation between an urgency severity scale (USS) based on a voiding diary with detrusor overactivity (DO) in a videourodynamic study in patients with an overactive bladder (OAB). Methods: We prospectively enrolled 190 consecutive patients with OAB. All patients were assessed using a USS and completed a 3-day voiding diary that recorded urgency and urgency urinary incontinence (UUI) episodes and the degree of urgency severity. The highest recorded USS score in the voiding diary was considered as the USS score. A videourodynamic study was performed, and the presence of increased bladder sensation (IBS) or DO was recorded. These clinical findings and videourodynamic data were analyzed. Results: This study enrolled 65 menand 125 women. The mean patient age was 66.4years (21–88). Among them, 82.6% had urodynamic DO, 7.9% had IBS, and 9.5% had normal urodynamic findings. The prevalence of DO was 50%, 76%, and 94% inpatients with a USS=2, 3, and4, respectively. Multivariate analysis indicated that OAB wet, high USS and UUI were significantly associated with the presence of DO. Urodynamic DO was present in most patients with OAB wet (94.1%) or USS = 4 (95.5%); however, only 63.9% of OAB dry patients had DO. In the OAB dry patients, 11/25 (44%) with USS = 2, 30/42(71%) with USS =3, and5/5(100%) with USS=4 had DO. Conclusions: A high USS recorded in conjunction with a voiding diary and OAB wet were strongly associated with urodynamic DO.
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