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目的探讨妊娠晚期初产妇下泌尿道尿控功能的变化及特点。方法应用会阴超声尿动力学检测方法,检测2003年1月至2005年12月在上海交通大学附属第六人民医院产科接受系统产前检查的初产妇共83例(研究组,孕36～40周,胎儿先露未衔接),及同期无分娩史、非妊娠、认知能力正常的育龄女性28例(对照组,排卵期)的下泌尿道尿控功能。下泌尿道尿控功能指标包括:最大尿道关闭压(MUCP)、最大静态尿道压(MUP)、功能尿道长度(FUL)、腹压漏尿点压(VLPP)、残余尿量(PVRBV)、膀胱初始尿意感容量(VFDV)。结果研究组产妇分娩的新生儿平均出生体重为(3504±404)g,MUP 为(1 10±22)cm H_2O(1 cm H_2O=0.098 kPa),MUCP 为(96±22)cm H_2O,FUL为(4J4±9)mm,对照组 MUP 为(98±20)cm H_2O,MUCP 为(79±8)cm H_2O,FUL 为(37±4)mm,两组各指标比较,差异均有统计学意义(P<0.01);研究组 VFDV 为(141±44)ml,PVRBV 为(6.2±2.7)ml,对照组为(149±41)ml,PVRBV 为(5.7±1.8)ml,两组比较,差异无统计学意义(P>0.05)。研究组有33例于孕24～38周出现漏尿症状,其中14例表现为 VLPP<90 cm H_2O。研究组中 VLPP≥90 cm H_2O和<90 cnl H_2O 者 MUP、MUCP 和 FUL 比较,差异均无统计学意义(P>0.05);研究组中有漏尿症状和无漏尿症状者除 MUCP 明显降低外,MUP、FUL 比较,差异均无统计学意义(P>0.05)。结论初产妇妊娠晚期的静态尿道关闭功能明显增强;而动态尿道关闭功能明显降低,并与漏尿症状相关;VFDV 无明显变化。
Objective To investigate the changes and characteristics of urinary control function in the first trimester of pregnancy. Methods The perineal ultrasound and urodynamic test was used to detect 83 cases of primipara from January 2003 to December 2005 in Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital. The study group was 36 to 40 weeks pregnant , The fetus did not reveal the first connection), and no history of childbirth over the same period, non-pregnant, cognitive ability of normal women of childbearing age 28 cases (control group, ovulation) urinary control function of the lower urinary tract. Lower urinary tract urinary control function indicators include maximum urethral closure pressure (MUCP), maximum static urethral pressure (MUP), functional urethral length (FUL), abdominal pressure (VLPP), residual urine volume (PVRBV) Initial urinary volume (VFDV). Results The average birth weight of newborns in the study group was 3504 ± 404 g, MUP was (1 10 ± 22) cm H 2 O (1 cm H 2 O = 0.098 kPa), MUCP was (96 ± 22) cm H 2 O, (4 ± 4) mm in the control group, (98 ± 20) cm H_2O in the control group, (79 ± 8) cm H_2O in the MUCP group and (37 ± 4) mm in the FUL group, with significant differences between the two groups (P <0.01). The VFDV in the study group was (141 ± 44) ml, the PVRBV was (6.2 ± 2.7) ml, the control group was (149 ± 41) ml and the PVRBV was (5.7 ± 1.8) No statistical significance (P> 0.05). In the study group, 33 cases showed leakage of urine during 24-38 weeks of pregnancy, of which 14 cases showed VLPP <90 cm H 2 O. There was no significant difference in MUP, MUCP and FUL between VLPP≥90 cm H_2O and <90 cnl H_2O in the study group (P> 0.05). MUCP was significantly lower in the study group There was no significant difference between MUP and FUL (P> 0.05). Conclusion The urethral closure function of primiparous women in the third trimester of pregnancy is obviously enhanced. However, the dynamic urethral closure function is significantly reduced, which is related to the leakage of urine. There is no significant change in VFDV.