女性盆腔脏器脱垂门诊患者临床特征分析

Clinical characteristics of outpatients with pelvic organ prolapse

目的调查女性盆腔脏器脱垂门诊患者的临床特征,了解主要症状的患病率及联合患病率,以及症状与脱垂部位、脱垂程度的关系。方法选取2009年11月至2010年4月在北京大学人民医院和航天中心医院妇科门诊因盆腔器官脱垂患者105例,按照现况调查方法进行现场问卷调查和妇科检查。结果发放问卷105份,全部回收,结果显示:①平均年龄(62.4±13.3)岁(28～88岁),70～79岁年龄段构成比最高;②阴道前壁脱垂90.4%,子宫脱垂77.2%,阴道后壁脱垂为68.3%;③常见症状有尿失禁(81.9%),自觉肿物脱至阴道口(74.3%),尿频(70.5%),尿不尽感(54.3%),便秘(52.4%),下腹坠胀(45.7%)。联合患病率主要有肿物脱出合并尿失禁(60%),尿失禁合并便秘(45.7%);④轻度脱垂(POP-QⅠ期+Ⅱ期)的临床症状:压力性尿失禁(53.3%),便秘(27.8%),自觉肿物脱出(20.8%),粪失禁(14.3%);重度脱垂(Ⅲ期+Ⅳ期):粪失禁(85.7%),自觉肿物脱出(79.2%),便秘(72.2%)。结论盆腔脏器脱垂门诊患者,常见症状有尿失禁、自觉阴道脱出肿物、尿频、尿不尽、便秘和下腹坠胀。轻度脱垂患者以排尿异常为主,重度脱垂患者,以阴道脱出物和排便症状为主,患者症状以多系统联合症状多见。临床医生应关注盆腔脏器脱垂患者的排尿和排便症状.

Objective To investigate the prevalence and co-morbidity of the main symptoms of out-patients with pelvic organ prolapse （POP）.Methods One hundred and five patients who consult in Peking University People＇s Hospital and Aerospace Centeral Hospital for vaginal prolapse or urine incontinence from November 2009 to April 2010 were analyzed retrospectively using the questionnaire interview and pelvic examination with POP-Q stages. Results The average age of these out-patients was （62.4 ± 13.3） years old,most of them were from 70 to 79 years old. Incidence of anterior vaginal wall prolapse,uterine prolapse and posterior vaginal wall prolapse were 90.4%,77.2%,and 68.3%,respectively. The common symptoms were urinary incontinence （UI,81.9%）,mass prolapse from vagina （74.3%）,micturition （70.5%） and urinary incompletability （54.3%）. The data showed that constipation,abdominal tenesmus and fecal incontinence were also common symptoms in outpatients （52.4%,45.7% and 20%,respectively）. Incidence of organ prolapse complicated with UI was in 60%,UI complicated with constipation was 45.7%. For mild patients （stageⅠ＋Ⅱ）,the common symptoms were stress urinary incontinence （53.3%） and constipation （27.8%）. As for severe patient （stageⅢ＋Ⅳ）,the common symptoms were fecal incontinence （85.7%）,prolapse feeling （79.2%） and constipation（72.2%）.Conclusions Anterior vaginal wall prolapse and uterine prolapse are more common in outpatients with POP. The common symptoms are urinary incontinence,tissue prolapse,frequent micturition,urinary incompletability,constipation and lower abdomen tenesmus.