不同分娩方式产妇产后早期尿动力学测定  

Short-term effect of different pattern of delivery on women urodynamics after labor

作　　者：董黎[1] 张曦[1] 文建国[2] 王庆伟[2] 车英玉[2] 张鹏[2] 刘奎[2] 齐艳[2] 张瑞丽[2] 

机构地区：[1]郑州大学第三附属医院妇产科,郑州450052 [2]郑州大学第一附属医院尿动力学中心

出　　处：《郑州大学学报（医学版）》2007年第6期1111-1113,共3页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金资助项目30571931;河南省杰出青年科学基金资助项目02120001100;河南省高校杰出科研人才创新工程基金资助项目2001KYCX004;河南省高等学校创新人才培养工程基金资助项目2002-2007

摘　　要：目的：初步探讨不同分娩方式对产后妇女近期下尿路功能的影响。方法：按照世界尿控协会推荐尿动力学标准检查方法对29例初产妇剖宫产后志愿者（AD组）和19例初产妇阴道分娩产后志愿者（VD组）在分娩后3～5d内进行尿动力学检查。以14例因上尿路疾病检查而下尿路功能正常的已婚未育妇女作对照。结果：AD组和VD组功能性膀胱容量、正常尿意膀胱压测定容量均低于对照组（P〈0．05），最大尿道压和最大尿道闭合压均高于对照组（P〈0．05），排尿后收缩发生率亦高于对照组（P〈0．05）。AD组最大尿道压和最大尿道闭合压高于VD组（P〈0．05），但AD组与VD组的AG值和尿道阻力因子（URA）均提示不存在膀胱出口梗阻。其余相关指标3组间比较差异均无统计学意义（P〉0．05）。结论：孕妇产后近期内多表现为膀胱感觉敏感，功能性膀胱容量下降，且尿道静态阻力增加，但膀胱排空能力无明显变化；阴道分娩产妇产后近期内尿道功能较好；2种分娩方式对产后膀胱功能的影响差异不大。Aim ： To investigate the short-term effect of different pattern of delivery on women urodynamics after labor. Methods：Urodynamics were measured on 29 volunteers after abdominal delivery （AD group） and 19 volunteers after vaginal delivery （ VD group） 3 - 5 days after labor. Fourteen got women married but have not born and undergoing upper urinary tract diseases but with normal lower urinary tract function were the control. Results ： Compared with those of the control group, Functional bladder volume （FBV） and normal desire cystometric capacity （NDCC） of AD group and VD group were lower（ P 〈 0.05 ） , while the Pure. max, Pure. closure, max and the DI incidence were higher（ P 〈 0.05 ）. The Pure. max, Pure. closure, max of AD group were higher than those of VD group （ P 〈 0.05 ） . There were no significant differences in Qmax, max cystometric capacity, bladder compliance, Pdet before voiding, Pdet at Qmax and Pdet. Max. void among the three groups（P 〉 0.05 ）. Abrams-Griffiths number （AG） and urethral resistance factor （URA） also showed no obstruction locating at the bladder of AD group and VD group. Conclusion ： It is suggested that bladders of women after labor are sensitive and static urethral pressure parameters increased, but the ability of emptying bladder is still normal during the shortterm. The urinary tract function in women after vaginal delivery is lower than that of women after abdominal delivery. The effect of the two patterns of delivery on bladder function have no difference.

关 键 词：尿失禁 分娩方式 下尿路功能 尿动力学 

分 类 号：R714.69[医药卫生—妇产科学]