女性压力性尿失禁的治疗进展

压力性尿失禁（ SUI）是中老年妇女的常见病,且随着个体年龄增加而增加,全球妇女该病患病率为10％～23％,中国成年女性患病率为18．9％。严重影响女性身心健康和生活质量,已成为社会公共卫生问题。随着我国人口老龄化,SUI发病率逐步增高,人们对生活质量的要求逐渐提高,SUI的诊治正日益受到重视。目前治疗SUI的方法分为保守治疗和手术治疗,本文就女性压力性尿失禁的治疗进展进行综述。     

肌源性干细胞治疗女性压力性尿失禁的研究进展

女性压力性尿失禁(stress urinary incontinence,SUI)是指在腹压增加的情况下,膀胱压力超过尿道阻力,尿液不自主溢出的一种盆底功能障碍性疾病,尤以中老年女性多发。近年来,SUI发病率逐年增高,具体发病机制不明。现今主流观点认为尿道括约肌功能缺陷是造成SUI的原因之一,因此恢复括约肌的正常结构和生理功能成为SUI治疗的关键。肌源性干细胞(muscle derived stem cells,MDSCs)来源丰富,在体外无诱导因素作用下即可向肌细胞方向分化。相关研究认为MDSCs注射可以在一定程度上促进肌纤维的再生,恢复括约肌的功能。因此,MDSCs或许是干细胞治疗SUI的理想选择之一,推动MDSCs治疗SUI的科学研究及临床应用具有极其重要的意义。本文将从干细胞特点及应用、MDSCs在SUI治疗中的研究进展及其所面临的局限性进行综述。     

女性压力性尿失禁手术方法的新进展

压力性尿失禁是中老年女性的常见病,严重影响女性身心健康和生活质量,已成为全球性公共卫生问题.轻中度压力性尿失禁保守治疗失败的患者或重度患者均可考虑手术治疗.手术治疗方法可分为3类:阴道前壁修补术、耻骨后膀胱尿道悬吊术和尿道中段悬吊术.本文通过对女性压力性尿失禁手术方式的进展和不同手术方法的优缺点比较,以期对压力性尿失禁...     

压力性尿失禁的研究进展

压力性尿失禁是一个严重的世界性的健康问题,给社会和个人带来明显的社会及经济压力,随着年龄的增加,尿失禁的发病率逐渐增加,严重影响了中老年女性的健康和生活质量,根据国外有关流行病学调查发现,女性尿失禁发生率在社区女性中的流行率范围为3%～17%,年轻和中年女性尿失禁发病率每年比老年女性的发病率低3%～8%[1].     

对压力性尿失禁的进一步认识

压力性尿失禁(SUI)是中老年女性的常见病。全球妇女该病患病率为10%～23%,严重影响女性身心健康和生活质量,已成为社会公共卫生问题。因此,了解SUI的流行病学特征、发病机制和治疗现况,是研究其发病危险因素和制定防治策略的基础。笔者拟就SUI诊治进展进行综述,针对其相关危险因素采取有效的预防措施,旨在降低SUI发病率,提高妇女健康水平和生活质量。     

产后压力性尿失禁的研究进展

产后压力性尿失禁是指继发于妊娠和分娩之后出现的压力性尿失禁症状,其对妇女身心有很大影响。该文对近年来产后压力性尿失禁的发病机制、高危因素与防治的研究进展进行了简要综述。     

产后压力性尿失禁的研究进展

产后压力性尿失禁是指继发于妊娠和分娩之后出现的压力性尿失禁症状，其对妇女身心有很大影响。该文对近年来产后压力性尿失禁的发病机制、高危因素与防治的研究进展进行了简要综述。     

In-Fast吊带系统治疗老年女性压力性尿失禁

目的:探讨In-Fast吊带系统治疗老年女性压力性尿失禁的效果。方法:采用In-Fast吊带系统治疗8例老年女性压力性尿失禁患者。结果:8例患者中7例术后症状完全消失,1例2月后出现轻度尿失禁。结论:In-Fast吊带系统是1种简单、微创、疗效确切的治疗老年女性压力性尿失禁的手术方法。     

压力性尿失禁新型非手术治疗的研究进展

女性压力性尿失禁(stress urinary incontinence,SUI)严重影响患者的生活质量,并带来了巨大的经济负担。SUI一线治疗为保守非手术治疗,但因保守非手术治疗方式多样,疗效和患者依从性不一,目前尚无一个集疗效、安全性、患者依从性等优点于一身的保守治疗方式。为了探寻最佳的SUI保守治疗方式,一些SUI治疗的新技术得到了广泛的研究。目前应用于SUI的新型治疗主要有电磁治疗、激光治疗和干细胞治疗。本文就这3种新型SUI治疗方式的研究进展进行综述。     

女性压力性尿失禁流行病学研究

目的调查城镇社区女性尿失禁发生的流行因素。方法随机对佛山市顺德区龙江镇5000名妇女妇科普查时同时问卷调查。结果问卷回收率93%。压力性尿失禁患病率29·85%,≥40岁占51·45%。结论压力性尿失禁的流行与年龄、多次的阴道分娩、难产、子宫脱垂、阴道前壁膨出、慢性咳嗽、便秘等多因素有关。     

虚拟现实研究女性压力性尿失禁膀胱尿道形态

目的 采用虚拟现实技术重建膀胱尿道并探讨膀胱尿道形态的变化与压力性尿失禁的相关性.方法 15例有典型临床表现并经尿动力确诊为压力性尿失禁患者和15例正常对照者行核磁共振扫描,采用虚拟现实技术对膀胱尿道等结构进行三维立体重建,观测静态和Valsalva动作时膀胱尿道后角、尿道倾斜角和膀胱颈移动度.结果 压力性尿失禁组静息和应力状态下膀胱尿道后角分别为121.9±6.8°和148.2±30.1°,均大于对照组的101.3±5.5°和113.5±2.9°,经比较差异均有统计学意义(t分别为9.049、4.431,均P<0.05),压力性尿失禁组静息和应力状态下尿道倾斜角分别为22.6±5.0°和38.8±14.7°,均大于对照组的7.7±1.4°和21.7±1.4°,经比较差异均有统计学意义(t分别为8.599、4.276,均P<0.05).压力性尿失禁组膀胱颈移动度为14.2±6.2mm,大于对照组的7.7±1.4mm,经比较差异有统计学意义(t=3.949,P<0.05).结论 虚拟现实系统是研究压力性尿失禁患者膀胱尿道形态学的有效方法,可以观察到压力性尿失禁患者膀胱颈后尿道明显下移.     

围绝经期女性压力性尿失禁的康复疗效观察

目的 观察联合外用雌激素软膏和盆底功能锻炼康复对围绝经期女性压力性尿失禁的治疗效果.方法 将90例45～55岁围绝经期压力性尿失禁妇女随机分为3组,分别接受盆底功能锻炼康复(组1)、雌激素软膏外用(组2)和盆底功能锻炼康复联合雌激素软膏外用(组3)的治疗方法,随访治疗后3个月的疗效,并对有关数据进行统计分析.结果 ①治疗后3个月,各组尿失禁量均比治疗前明显减少(t分别为28.75、36.49、33.25,均P<0.01),组1(2.48±1.20g)与组3(1.84±1.62g)治疗后尿失禁量少于组2(4.25±2.42g);②组1总有效率高于组2(96.67% vs 70.00%;χ2=7.68,P<0.01),组3总有效率高于组2(100.00% vs 70.00%,P=0.00);③治疗后3个月与治疗前比较,3组Kupperman评分均明显减低,其中组2(16.80±4.21)、组3(16.23±3.38)评分均低于组1(38.41±6.82,t值分别为14.81、15.99,均P<0.01).结论 单用盆底功能锻炼康复对改善尿失禁效果明显,单用雌激素软膏外用可有效减轻围绝经期症状,盆底功能锻炼康复联合雌激素软膏外用不仅可治疗围绝经期女性尿失禁,同时可减轻围绝经期症状.     

绝经后妇女胰岛素抵抗与性激素关系研究进展

绝经后妇女性激素的改变与胰岛素抵抗的产生有关。雄激素、性激素结合球蛋白参与了胰岛素抵抗的形成 ,高水平的雌激素可引起胰岛素抵抗 ,生理剂量的雌激素可提高绝经后妇女的胰岛素敏感性 ,降低胰岛素抵抗 ,孕激素与胰岛素抵抗的关系尚需进一步研究 ,该文就近年来绝经后妇女胰岛素抵抗与性激素变化关系的研究进展作以综述。     

不同时期不孕症患者激素水平变化的对比研究

目的:探究不同时期不孕症患者的性激素水平变化情况,为临床不孕症的诊疗提供依据.方法:研究对象选取为2014.1~2015.1之间我院收治的80例不孕症患者,分为卵泡期33例,排卵期24例,黄体期23例,选取同期健康体检女性104例作为对照,同样根据分为卵泡期41例,排卵期34例,黄体期29例,分别对两组患者进行卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇(Estradiol,E2)、垂体泌乳素(prolactin,PRL)、孕酮(Progesterone,P)、睾酮(Testosterone,T)6项激素水平检测,并对检测结果进行对比分析.结果:卵泡期不孕症患者的FSH、E2、PRL、P、T水平与对照组相比存在显著差异(P<0.05);排卵期不孕症患者的FSH、LH、E2、P、T水平与对照组相比存在显著差异(P<0.05);黄体期不孕症患者的LH、PRL、P水平与对照组相比存在显著差异(P<0.05).结论:性激素水平的变化与女性不孕症的发生有密切相关,且随着月经周期的变化存在一定差异,针对性的检验可以作为不孕症诊断和治疗的相关依据.     

产褥期妇女康复研究进展

产褥期是产妇分娩后身体各器官复原的一个重要时期,也是新生儿健康成长的关键时期.产褥期妇女在生殖系统、泌尿系统、消化系统的复旧方面有着显著的变化,心理处于情感脆弱阶段.目前报道,足部按摩可促进产妇产后康复、家庭亲密度和适应性,对产后康复起到有益作用;"现代月子"有利于产褥期康复;健康教育在产褥期发挥着主导作用.     

Cohort study of the effects of dietary habit on changes of BMI in middle-aged women

OBJECTIVES: The Lifestyle Study Group of the Life Planning Center developed the "Lifestyle Survey for Prevention of Cardiovascular Diseases (LPC Lifestyle Questionnaire) in 1982, and conducted a baseline study (questionnaire survey of lifestyle, physical measurements, blood pressure measurement and blood tests) in two cohorts residing in an agricultural/fishing village and an urban area in 1991. Based on the baseline data of 1991, the present study aimed to elucidate the effect of dietary lifestyle on changes of BMI in a cohort of a total of 173 persons residing in the agricultural/fishing village and the urban area. METHODS: Discriminant analysis was conducted using delta BMI as a dependent variable, and the 1991 scores of six dietary lifestyle scales, age, BMI and region as independent variables. The following results were obtained. RESULTS: 1. When the mean scores of 6 dietary lifestyle scales, age and BMI in the 1991 survey were compared among three sub-groups classified by the changes of BMI, significant intergroup differences were observed in sugar content score (tendency of high intake of snacks and juice), age and BMI. Compared to the -1 < or = delta BMI < +1 and -5 < or = delta BMI < -1 groups, the +1 < or = delta BMI < group had the highest sugar content score and the lowest age within group. BMI was the lowest in the group with -1 < or = delta BMI < +1. 2. When discriminant analysis was conducted using delta BMI as a dependent variable, and the scores of six dietary lifestyle scales, age, BMI in the 1991 survey and region as independent variables, the results showed that sugar content score, cooking initiative score (interest in new dishes and modifying cooking for health), age and BMI were statistically significant for the discrimination. CONCLUSIONS: The findings suggest that even in young subjects with low BMI, if the sugar content score and cooking initiative score are high, there is a high possibility of increased BMI in the future.     

Stress urinary incontinence in women: review and update on neurological control

BACKGROUND: Female stress urinary incontinence (SUI) is a common disease that involves leakage of urine during coughing, sneezing, or other increases in intraabdominal pressure. Treatments for SUI include pelvic floor muscle training, electrical stimulation, surgery, and off-label alpha-adrenergic agonists that stimulate contraction of the urethral smooth muscle. None of these treatments is universally or completely effective, and because drug therapy with the alpha- adrenergic agonists phenylpropanolamine and ephedrine can cause serious pressor adverse effects, the former has been banned in the United States, and the latter is under scrutiny. The central nervous system (CNS) affects reflexes that control urine storage and micturition, and norepinephrine and serotonin play a key role in maintaining storage capability by means of contraction of the external striated muscle of the urethral sphincter. Duloxetine hydrochloride, which inhibits reuptake of both of these neurotransmitters, has been shown to promote striated urethral sphincter contraction in animal models and to reduce the incidence of involuntary urine release in women with SUI without interfering with micturition. CONCLUSION: Neuromodulation of noradrenergic and serotonergic neurotransmitters with such drugs as duloxetine provides an additional treatment option for women with SUI.     

铅作业女工子女神经行为和神经生化改变的配对研究

目的　通过观察铅作业女工子女（６ ～１０ 岁） 及１∶１ 对照组血铅、发铅、神经行为及生化的差异,了解铅对神经行为的影响及其生物学基础。方法　采用ＷＨＯ 推荐的神经行为测试组合中适宜儿童的四项测定神经行为功能,采用高效液相色谱法－ 电化学法联检测定尿中高香草酸（ＨＶＡ） 和香草扁桃酸（ＶＡＭ） 的浓度。所得资料用ＳＰＳＳ 软件进行配对ｔ 检验。结果　接触组尿液中ＨＶＡ 和ＶＭＡ 减少（ Ｐ＜０－００１） ,数字广度及最快反应时间得分减少（ Ｐ＜ ０－００１） 。结论　铅对女工子代的ＨＶＡ、ＶＭＡ、数字广度及最快反应时等神经行为生化指标有影响。     

孕产妇纵向心理变化特征与影响因素分析

目的 分析不同孕期及产后妇女的心理变化规律及其影响因素,以便及时有效地开展孕期心理保健和有针对性的心理干预.方法 采用SCL-90和孕妇临床结构访谈法,对1 132名被试者(孕期6～39周和产后42天)进行了心理状态和社会-文化-家庭影响因素评估分析,运用Kruskal-Wallis Test与非条件Logistic回归分析,探索不同孕产妇心理状态变化特点和规律.结果 早孕组、中孕组、晚孕组和产后组之间,在总分、躯体化、人际关系敏感、抑郁、焦虑、敌对、恐怖和精神病性症状等因子上差异均有统计学意义(均P ＜0.05);其中躯体化、人际关系敏感2项以早孕组最高,总分、抑郁、焦虑、敌对、恐怖、精神病性症状6项以中孕组最高,晚孕组和产后组均较低.非条件Logistic回归分析显示,孕妇的年龄、文化水平、当前身体感受、对工作学习影响、担心胎儿畸形等项目均进入回归方程(均P＜0.05).孕妇年龄、文化水平的OR值依次为0.929、0.780,且OR值的95％ CI均小于1,为孕妇心理健康的保护因素;当前身体感受、对自己工作与学习有影响、担心胎儿畸形OR值依次为1.260、1.208、1.259,且OR值的95％ CI均大于1,是孕妇心理健康的危险因素,其中对情绪影响最大的是担心胎儿畸形,Wald值为6.495. 结论 ①怀孕妇女在不同孕期均有某些心理状态变化以及负性情绪体验,但不同孕期各有其特点;②社会-文化-家庭等因素对孕妇心理状态变化具有不同的影响.     

Dietary changes in Vietnamese marriage immigrant women: The KoGES follow-up study

BACKGROUND/OBJECTIVES

The immigrant population has grown considerably in South Korea since the early 1990s due to international marriages. Dietary changes in immigrants are an important issue, because they are related to health and disease patterns. This study was conducted to compare changes in dietary intake between baseline and follow-up periods.

SUBJECTS/METHODS

Two hundreds thirty three Vietnamese female married immigrants. Baseline data were collected during 2006-2009, and the follow-up data were collected during 2008 and 2010. Food consumption was assessed using a 1-day 24-hour recall.

RESULTS

The amount of the total food consumed (P < 0.001) including that of cereals (P = 0.004), vegetables (P = 0.003), and fruits (P = 0.002) decreased at follow-up compared to that at baseline, whereas consumption of milk and dairy products increased (P = 0.004). Accordingly, the overall energy and nutrient intake decreased at follow-up, including carbohydrates (P = 0.012), protein (P = 0.021), fiber (P = 0.008), iron (P = 0.009), zinc (P = 0.006), and folate (P = 0.002). Among various anthropometric and biochemical variables, mean skeletal muscle mass decreased (P = 0.012), plasma high density lipoprotein-cholesterol increased, (P = 0.020) and high sensitivity C-reactive protein decreased at follow-up (P < 0.001).

CONCLUSIONS

A long-term follow-up study is needed to investigate the association between changes in food and nutrient intake and anthropometric and biochemical variables in these Vietnamese female marriage immigrants.