分娩镇痛对初产妇产后尿失禁的影响研究

The effect of labor analgesia on the postpartum urinary incontinence of primiparas

目的探讨分娩镇痛对初产妇产后尿失禁的影响。方法收集2014年3月至2015年11月广西壮族自治区妇幼保健院足月经阴道分娩的单胎初产妇478例,采用国际尿失禁标准问卷(改良的布里斯托问卷,ICIQ-FLUTS)调查产后尿失禁发生情况。比较镇痛组与非镇痛组产妇分娩裂伤、早期尿失禁发生率。结果镇痛组分娩裂伤率66.67%(146/219)与非镇痛组61.00%(158/259)比较,差异无统计学意义(χ~2=1.644,P>0.05)。镇痛组尿失禁发生率24.66%(54/219),高于非镇痛组12.36%(32/259),差异有统计学意义(χ~2=12.172,P<0.05)。两组产妇分娩侧切率差异无统计学意义(χ~2=0.388,P>0.05)。结论分娩镇痛是产后早期尿失禁的可能危险因素,在一定程度上影响尿失禁的发生。

Objective To explore the effect of labor analgesia on postpartum urinary incontinence of primiparas. Methods A retrospective case-control study was conducted among a cohort of 478 primiparas who had term singleton pregnancy and vaginal delivery in our hospital from March 2014 to November 2015.They were divided into labor analgesia group and control group.The international standard for urinary incontinence questionnaire（ICIQ-FLUTS）was used for the survey of postpartum urinary incontinence.The incidences of both delivery laceration and urinary incontinence were compared. Results The incidence of delivery laceration was66.67%（146/219）among women in labor analgesic group and was 61.00%（158/259）in control group,the difference was not statistically significant（χ^2=1.644,P〈0.05）.However,the incidence of urinary incontinence was much higher among women with labor analgesia compared with controls（24.66%vs 12.36%,χ^2=12.172,P〈0.05）.No statistically significant difference in the incidence of lateral episiotomies was found between two groups（χ^2=0.388,P〈0.05）. Conclusions Labor analgesia may be a risk factor of early postpartum urinary incontinence of primiparas.