Effect Of Application Of Neostigmine Accompanied With Lidocaine On Acute Postpartum Urinary Retention

Background Postpartum urinary retention is a common postpartum complication,which bring great pain to the puerperal women,leading to cesarean section,postpartum hemorrhage,and puerperous complication.Treatment for postpartum urinary retention is not satisfactory at present.Study shows the increase of detrusor excitability may play an important role in the pathogenesis of postpartum urinary retention.Connexin43 is a member of gap connexins family,the expression of connexins in detrusor will affect detrusor contraction and alter retention of urine.Objective To explore the clinical therapeutic effect of neostigmine accompanied with lidocaine on postnatal urinary retention,and try to find out the effect on the expression of Cx43 after treatment in postnatal urinary retention rats.To explore a good preventive treatment and curative effect for postnatal urinary retention.Methods 1 Clinical study: patients Included in the standard of postnatal urinary retention,patients were randomly divided into groups with different medicine treatment.the degree Before and after the intervention of urinary retentionwere compared and the clinical effectiveness of each group were observed.2 Animal experiment(1)Replicate the rats model,Bladder physiology index and excitability and contractility of detrusor were detected after drug intervention.(2)Take the rats of bladder tissue,and the expression of Cx43 in bladder detrusor cells were detected by ELISA and RT-PCR.Result 1.Clinical study(1)First micturition and single volume in united group were higher than simple medicine group.Retention of urine group has Minimum micturition volume.The time of first maturations were shorter in united group than that of simple medicine group.Retention of urine group spent most time on first maturations.Residual urine volume was minimum in united group.(2)The combined medicine group was significantly superior to the simple medicine group.The treatment effect of the treatment group was higher than that of the control group.2.Animal experiment(1)First micturition in united group was highest among groups.Retention of urine group has Minimum first micturition volume.Retention of urine group spent most time on first maturations.The combined medicine group was significantly superior to the simple medicine group in first maturations time.The combined medicine group was higher than the simple medicine group in Residual urine volume.(2)Urinary retention group has the largest bladder capacity.The combined medicine group was lower than the simple medicine group in bladder capacity and wet weight.(3)Urinary retention group has the largest minimum tension and amplitude,the combined medicine group was lower than the simple medicine group in minimum tension and amplitude.Minimum frequency was found in urinary retention group.The frequency of the combined medicine group was lower than that of the simple medicine group.(4)The maximum bladder compliance was found in urinary retention group.The combined medicine group was lower than the simple medicine group in bladder compliance.Urinary bladder leak point pressure was maximum in urinary retention group.The urinary bladder leak point pressure of the combined medicine group was lower than that of the simple medicine group.(5)Highest of Cx43 protein contents was found in urinary retention group.The combined medicine group was lower than the simple medicine group in Cx43 protein contents.Conclusion Application of neostigmine accompanied with lidocaine could be used effectively for the treatment of acute postpartum urinary retention,which can improve the bladder detrusor compliance,improve spontaneous excitatory and enhance muscle contraction force.It probably is that the combined medicine is superior to the simple medicine on clinical symptoms of acute postpartum urinary retention.