妊娠对初产女性下尿路尿控功能影响的研究  

Impact of function in continence of female lower urinary tract in nulliparous women during the late third trimester pregnancy

作　　者：岳廷棉[1] 罗来敏[1] 吴氢凯[1] 

机构地区：[1]上海交通大学附属第六人民医院妇产科,上海200233

出　　处：《中国妇幼保健》2007年第8期1026-1029,共4页Maternal and Child Health Care of China

摘　　要：目的:探讨初产女性孕晚期控尿功能及盆底肌力的变化。方法:按照入选标准入组48例,根据尿失禁问卷调查分有漏尿组24例和无漏尿组24例,妊娠满38周至临产前采用前庭超声尿动力学和肌电图检测。结果:有漏尿组尿道膀胱连接部移动度显著增大(P<0.05),收缩和静息状态下肛提肌肌电压差显著减小(P<0.05);腹压漏尿点压<90 cmH2O 5例均有漏尿症状,其尿道膀胱连接部移动度显著增大(P<0.05),最大尿道压、功能性尿道长度显著减小(P<0.05),收缩状态下肛提肌肌电显著减弱(P<0.05);所有孕妇膀胱储尿功能正常。结论:初产女性孕晚期下尿路解剖位置和功能发生变化,部分有漏尿症状的孕妇存在下尿路功能损害,盆底肌力量减弱,控尿能力下降;膀胱储尿功能并没有发生明显异常改变。Objective： To investigate change of function in continence of female lower urinary tract and pelvic floor strength in nulliparous women during the late third trimester pregnancy undergoing measurement. Methods ： 48 nulliparous women were recruited and examined by perineal sonographic urodynamics and electromyogram at 38 gestational weeks before threatened labor. 48 nulliparous women were divided into two groups -24 women with urinary incontinence and 24 women without urinary incontinence, by urinary incontinence questionnaire. Results： UVJ - M of women with urinary incontinence were obviously increased compared to that of women without urinary incontinence （P 〈 0. 05） ; The difference of levator rest and contract strength were obviously decreased in women without urinary incontinence （P 〈0. 05） ; 5 women with VLPP 〈90 cm H2O had urinary incontinence symptom, UVJ -M were obviously increased, MUP, FUL and contract levator strength was obviously decreased compared to those with VLPP ≥90 cm H2O （P 〈 0. 05 ） ; Function of urine storage in 48 women was normal. Conclusion： The change of anatomy site and function of female lower urinary tract and the trauma of female pelvic floor muscles during the late third trimester pregnancy in nulliparous women occurs, the change and trauma results in decrease of urinary continence in part of women with urinary incontinence; Function of urine storage in 48 women is normal.

关 键 词：妊娠 压力性尿失禁 超声尿动力学 肌电图 

分 类 号：R714[医药卫生—妇产科学]