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一、特异性影响 绝经最明显的作用是雌激素丧失。一些研究者证实雌激素缺乏能影响结缔组织,特别能影响子宫颈横韧带和子宫骨盆横韧带使其失去对盆腔器官的支持功能,从而导致盆腔器官脱垂并影响排尿控制和膀胱排空。 尿道和膀胱三角上皮与阴道上皮都受雌激素影响,随着绝经这些上皮发生萎缩、僵硬和变脆。已经发现雌激素能将尿道周围粘膜下的小血管的管腔扩大4倍,从而为增加关闭尿道的压力提供了基础。这些生理学作用提示排尿控制的两个重要机制——即尿道膀胱三角和尿道关闭压力随绝经能发生改变。 由于老年妇女尿道上皮比较薄弱,尿道壁也比较萎缩和僵硬,所以老年妇女就常常不能通过排尿将这些致病菌清除。于是这些致病菌就容易从尿道上升进入膀胱而引起频发的尿路感染。尽管应用抗
First, the specific effect of menopause is the most obvious role of estrogen loss. Some investigators have confirmed that estrogen deficiency can affect connective tissue. In particular, it can affect the transverse cervical ligament of the cervix and the uterine pelvic transverse ligament to lose support for pelvic organs, leading to pelvic organ prolapse and affecting voiding control and bladder emptying. Urethra and bladder trigone epithelium and vaginal epithelium are affected by estrogen, with menopause, these epithelial atrophy, stiff and brittle. Estrogen has been found to amplify the lumen of small submucosal blood vessels around the urethra four times, thus providing a basis for increasing the pressure to close the urethra. These physiological effects suggest two important mechanisms of micturition control - the urinary bladder trigone and urethral closure pressure with menopause can change. Due to the relatively weak urinary tract epithelium of older women, the urethral wall is also relatively atrophied and stiff, so older women often can not clear these pathogenic bacteria through urination. So these pathogens can easily rise from the urethra into the bladder and cause frequent urinary tract infections. Despite the application of anti