莱芜市女性产后盆底功能障碍性疾病流行病学研究

Epidemiological Study of Pelvic Floor Dysfunction among Postpartum Women in Laiwu City

目的对莱芜市产后妇女盆底功能障碍性疾病(pelvic floor dysfunction,PFD)的流行病学特征进行调查,并以此为依据,制定符合本地区的防治策略,提高产后妇女生活质量。方法 2011年1月1日—2012年5月1日在莱芜市妇幼保健院进行产后1年内PFD筛查的女性1574例,进行调查问卷(内容涵盖一般情况、产科史、家族史、既往疾病及手术史)、妇科检查,对压力性尿失禁及阴道壁脱垂相关因素经单因素分析χ2检验、多因素Logistic回归分析筛选出高危因素。结果筛选出压力性尿失禁的高危因素:年龄(≥40岁占39.22%)、体力劳动强度(重体力劳动者占32.77%)、分娩方式(阴道分娩≥2次占38.20%)、慢性咳嗽史(有慢性咳嗽史占25.58%)、未上过孕妇学校(19.13%);阴道脱垂的高危因素:年龄(≥40岁占78.43%)、体力劳动强度(重体力劳动者占85.71%)、BMI(≥28 kg/m2占85.19%)、分娩方式(阴道分娩≥2次占85.11%)、盆腔手术史(75.00%)。结论注重号召适龄婚育、适度体力劳动、提倡计划生育、积极防治慢性疾病如咳嗽等、进一步扩大孕妇学校影响力,争取使所有的孕妇都接受科学规范的孕期产后教育,提高生活质量。

Objective To investigate the epidemiological characteristics of pelvic floor dysfunction（PFD） among postpar- tum women in Laiwu city, so as to develop prevention and control strategies and improve the quality of life of postpartum women. Methods A questionnaire survey covering general conditions, obstetric history, family history, past medical and surgical history was conducted among 1574 cases of postpartum women receiving PFD screening one year after giving birth from January 1, 2011 to May 1, 2012, as well as gynecological examination. ~ test and multivariate logistic regression a- nalysis were used to screen fro high - risk factors associated with stress urinary incontinence （SUI） and vaginal wall pro- lapse. Results Risk factors for SUI： age（ 340 years, 39.22% ）, physical strength（ heavy manual workers, 32.77% ）, mode of delivery（ vaginal delivery2 times or higher, 38.20% ） , history of chronic cough （25.58%）, no experience of at- tending pregnant women school（ 19. 13%）. Risk factors for vaginal prolapse： age（ 340 years, 78.43% ）, physical strength（heavy manual workers, 85.71% ）, body mass index（ 328 kg/m2, 85.19% ）, mode of delivery（vaginal delivery 2 times or higher,85.11% ）, history of pelvic surgery（75.00% ）. Conclusions More attention should paid on the age of marriage and childbearing, moderate physical labor, family planning, prevention and control of chronic diseases such as cough, further promotion of the influence of pregnant school, so that all the pregnant may have scientific postpartum educa- tion and improve their quality of life.