盆底障碍性疾病盆底自主收缩肌肉力量研究  

Pelvic floor muscle function in normal women and the patients with pelvic floor dysfunction

作　　者：海宁[1] 朱兰[1] 郎景和[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730

出　　处：《生殖医学杂志》2008年第5期321-324,共4页Journal of Reproductive Medicine

摘　　要：目的比较正常人和盆底障碍性疾病(PFD)患者的盆底肌肉功能。方法对2007年11月至2008年4月在本院就诊的压力性尿失禁(SUI)、盆腔器官脱垂(POP)、POP合并SUI患者以及健康对照组各10例,行阴道指诊、阴道挤压力检测盆底肌肉收缩力量进行评估。结果肛提肌肌肉指诊力量和阴道挤压力呈正相关(r=0.549,P<0.05)。对照组阴道指诊肌力等级为(4.1±0.8),阴道挤压压力为(38.4±21.1)mmH2O,15 s内可自主收缩肛提肌(6.0±1.2)次,收缩持续时间为(4.78±1.78)s。SUI组、POP组、SUI+POP组阴道指诊肌力等级分别为(2.6±0.7)(、3.2±1.2)和(3.0±1.4),均显著低于对照组(P<0.05);阴道内挤压压力分别为(20.2±11.1)、(13.8±10.3)、(20.0±10.4)mmH2O,均显著低于对照组(P<0.05)。SUI组15 s内可自主收缩肛提肌(3.6±1.0)次,显著少于对照组(P<0.05),收缩持续时间为(2.40±1.35)s,与对照组比较显著缩短(P<0.05)。结论肛提肌的阴道指诊的肌力测定,简单易行,可在临床广泛应用。PFD患者普遍存在肛提肌肉收缩力量减弱。SUI患者收缩速率慢、收缩持续时间短,不能对抗连续的腹压增高可能是SUI的发病机制。Objectives： To compare the pelvic floor muscle function between the women with pelvic floor dysfunction and normal controls Methods： Vaginal palpation and dynamometric measurements were used to assess the pelvic floor muscle strength of 10 women suffering from stress urinary ineontinence（SUI）, 10 with uterus prolapse, 10 with uterus prolapse complicating with stress urinary incontinence and 10 normal women. Results from the palpation test were compared with measurements of vaginal squeeze pressure using dynamometric device. Duration and speed of pelvic floor muscle contraction were compared between SUI group and control group. Results： The inter rater reliability for vaginal palpation according to the dynamometric measurements was 0. 549 measured by Spearman＇s rho. The women with pelvic floor dysfunction demonstrated lower force of pelvic floor muscle. Duration and speed of pelvic floor muscle contraction were both lower in the SUI group than in control group. Conclusion： Vaginal palpation is simple and valid to measure pelvic floor muscle strength. The function of pelvic floor muscle is impaired in women with pelvic floor dysfunction.

关 键 词：压力性尿失禁 盆底肌肉 自主收缩力量 盆腔脏器脱垂 

分 类 号：R711.6[医药卫生—妇产科学]