尿动力学测试|Overview
The urodynamics study is a test used to assess how well your child's bladder and urethral sphincter are doing their jobs of collecting, holding and releasing urine.
- Normally, muscles and nerves of the urinary system work together to control the release of urine. Nerves carry messages from the bladder to the spinal cord and then to the brain, as well as messages from the brain to the muscles of the bladder and sphincter, telling them either to tighten or release.
- 尿动力学测试是评估膀胱如何执行其两个主要功能的绝佳方法：填充和排空。
测试期间会发生什么？
你孩子的尿流是衡量他或她rinates in a special, privately placed toilet. Then a thin, flexible tube is placed in your child's bladder to fill it slowly with a warm saltwater solution. At the same time, bladder pressures are monitored and the presence or absence of premature bladder contractions is noted, along with any sensations experienced by your child. Other aspects of the bladder that are monitored include its emptying characteristics (whether or not the bladder empties completely with normal pressures, high pressures or low pressures.)
该研究可以有多达五个部分：
- 尿流量（也称为Uroflow）：您的孩子将被要求在记录尿液实际流动的计算机上的特殊厕所中小便。它测量第二流量和尿液的总体积。
- 导管插入术：将轻轻插入一个称为导管的纤维塑料管中，并插入孩子的尿道中，并前进到膀胱中，以排出其中剩下的任何尿液。然后将其松散地胶带胶带，因此在进一步的测试中不会出现。
- Urethral pressure profile (UPP): The catheter is slowly drawn through the urethra, while a computer measures pressures in the urethra.
- 膀胱图（CMG）：膀胱充满了通过导管的温暖盐水，当膀胱满时，您的孩子需要用导管排尿，以便计算机可以继续记录压力。这使医生可以监测膀胱压力。
- 肌电图（EMG）：如果您的儿科泌尿科医生怀疑您孩子病情的神经系统原因，则可能建议使用EMG。对于测试的这一部分，将电极放入外部尿括约肌中。当膀胱被填充和清空时，医生将记录孩子的括约肌反射和反应。
谁应该接受尿动力学测试，什么时候应该进行测试？
Children withurinary incontinencemay need a urodynamic study if the problem hasn't been fixed by simpler methods of treatment, such as drugs to help achieve dryness and behavioral modification strategies.
- For children with recurringurinary infection, urodynamics studies are usually performed after the child has been on continued long-term antibiotics, but is still having episodes of incontinence or recurring infection.
- 当X射线成像揭示出多种尿感染的儿童的特殊异常时，也可能需要研究。
- 当成像研究揭示上尿路外观变化时，也可以进行研究，这表明膀胱功能发生了变化。
For children with known neurological conditions, such as骨髓增生，研究通常在新生儿期间进行，因此可以尽快开始治疗。如果这些孩子年龄较大，也需要研究，如果他们没有通过简单的间歇性导管插入术和有助于使膀胱瘫痪的药物实现延续性。
在患有解剖状况的儿童中，导致尿失禁，例如膀胱外肌/EPISPADIASor肛门直肠畸形, urodynamics studies are recommended as soon as the diagnosis is made and after initial treatments fail to correct the incontinence. Testing helps guide the pediatric urologist toward other means of therapy and improves the efficiency of your child's treatment plan.
How do I plan for the testing?
为了确保您的孩子在测试时没有尿感染，您的儿科泌尿科医生将希望在预定日期前一周获得尿液培养。
On the day of the test, it is important to make sure that your child comes to the urodynamics suite with a relatively full bladder (if toilet trained) so that he or she can urinate voluntarily. A full bladder is not crucial for children who cannot void voluntarily and require catheterization to empty the bladder.
准备孩子也很重要，解释了为什么测试很重要，它旨在完成的工作以及如何改善孩子的健康。了解测试的目的及其所有方面都可能使您的孩子更容易测试。
为什么波士顿儿童医院使用尿动力学测试
By tracking how the bladder fills and empties, physicians can get clues to why a child may haveurinary incontinenceor尿感染. Urodynamics testing can also assess any abnormalities of the upper urinary tract.
当怀疑或诊断以下情况时，通常进行尿动力学研究：