彩色多普勒超声观测妊娠期输尿管排尿的临床意义

Clinic Significance on Monitoring Ureteral Jets in Pregnancy by Color Doppler Ultrasound

目的应用彩色多普勒超声观测输尿管膀胱开口处排尿情况,探讨妊娠期输尿管排尿的特点及临床意义,以减少妊娠期妇女泌尿系感染性疾病的发生.方法选择妊娠妇女150例,分别于早孕期（11-13周）、中孕期（20-24周）、晚孕期（32-36周）进行检查,150例健康妇女作为对照.饮水500 mL后45-60 min时,应用彩色多普勒超声观测输尿管膀胱开口处的尿流形态、排尿频率及尿流速度.结果早孕期与对照组比较,尿流速度、排尿频率差异无统计学意义;中孕期及晚孕期时输尿管排尿频率增高,但尿流速度减低,且右侧尿流速度减低更为明显;尿流速度以仰卧位时最低,对侧卧位时最高,差异具有统计学意义,而排尿频率受体位影响不明显.结论中、晚孕期输尿管排尿的改变与子宫压迫输尿管密切相关,适当卧姿可改善输尿管排尿状况.

Objective To explore the characteristic and significance of urination and the morphology of ureteral jets in pregnancy by color Doppler ultrasound in order to decrease the rate of urinary system infection. Methods The morphology,frequency and speed of ureteral jets were observed by color Doppler ultrasound in 150 pregnancy women of the first（11-13 weeks）,the second（20 -24 weeks） and the third（32 -36 weeks） trimester after drinking 500 mL water for 45~60 minutes. 150 Healthy women were taken as the control group. Results Compared with those in the control group,the differences in the speed and frequency of urination were not significant in the first trimester;the frequency was increased while the speed was decreased especial the right one in the second and third trimester. During the pregnancy,the urination speed was lowest when the woman was in supine position and highest in left recumbent position,and there was no obvious difference in the frequency when the women change their position between two groups. Conclusion The change in the ureteral urination during the middle and late pregnancy is closely related to the compression of uterus. The compression can be relieved by changing positions and it can ameliorate the conditions of urination.