北京市社区中老年妇女泌尿生殖道及盆底功能障碍性疾病相关因素分析

Investigation of related factors of genitourinary syndrome and pelvic floor dysfunction in middle-aged and older women in Beijing community

目的调查北京市社区中老年妇女泌尿生殖道症状及盆底功能障碍（pelvic floor dysfunction,PFD）的患病情况及其危险因素。方法选择2013年10—12月在北京市第二医院及月坛社区卫生服务中心所辖范围内3 000名40-70岁的女性进行调查。问卷内容包括一般资料、盆底功能障碍问卷简表（pelvic floor distress inventory-short form 20,PFDI-20）。结果 3 000名女性中,回收有效问卷2 601份,有效应答率86.70%,平均年龄为（53.61±7.06）岁。PFD患病率为65.24%（1 697/2 601）。阴道分娩者与剖宫产者PDF症状的患病率分别为68.23%（1 239/1 816）和58.90%（364/618）。阴道分娩者PFD患病率高于剖宫产者,两者比较,差异有统计学意义（P〈0.001）。PFD的危险因素为围绝经期及绝经期（OR=1.740,P〈0.05;OR=1.147,P〈0.05）、患有躯体疾病（OR=1.489,P〈0.001）、使用围绝经期药物（OR=1.748,P〈0.001）、患有外阴阴道萎缩（OR=2.840,P〈0.001）。保护因素为剖宫产（OR=0.683,P〈0.001）,高中学历（OR=0.758,P〈0.05）。结论盆底功能障碍的发生与月经情况、分娩方式、躯体疾病、围绝经期药物应用情况及学历有关。

Objective To investigate the prevalence of genitourinary syndrome of menopause and pelvic floor dysfunction（PFD） among middle-aged and older women in Beijing community and to assess the related factors. Methods Three thousand copies of a questionnaire were sent to the 40-70 year-old-women who had undergone two cancer screening tests in two communities（Yuetan Community Health Service Center of Fu Xing Hospital and The Second Hospital of Beijing）. The questionnaire included general situation, pelvic floor distress inventory-short form 20（PFDI-20） which was used to measure PFD. Results 2 601 questionnaires were retrieved from 3 000 cases, the effective response rate was 86.70%. The average age was（53.61±7.06） years, the prevalence of PFD was 65.24%（1 697/2 601）. The prevalence of PFD in vaginal delivery and cesarean section was 68.23%（1 239/1 816） and 58.90%（364/618）, respectively. The prevalence of PFD in vaginal delivery was higher than that in cesarean section, and the difference was statistically significant（P〈0.001）. The risk factors of PFD were perimenopausal and postmenopausal（OR=1.740, P〈0.05; OR=1.147, P〈0.05）, somatic disease（OR=1.489, P〈0.001）, menopausal medication（OR =1.748, P〈0.001）, atrophic vaginitis（OR =2.840, P〈0.001）. The protective factors were cesarean section（OR=0.683, P〈0.001）, high school education（OR=0.758, P〈0.05）. Conclusions The occurrence of pelvic floor dysfunction is related to menstruation, delivery mode, somatic diseases, menopausal drug application and education.