云南省女性压力性尿失禁发生的产科相关危险因素

Analysis of Obstetrical Risk Factors Related to Stress Urinary Incontinence in Female in Yunnan Province

目的 调查云南省体检妇女压力性尿失禁(SUI)发生的产科危险因素及相关分析。方法 连续选取2016年8月至2017年3月在云南省干部体检中心体检的已婚女性3 497例,发生压力性尿失禁 225例,同时随机抽取同期未发生压力性尿失禁 264例,排除旧法接生、产程时间及新生儿体重记不清的的受检女性,分析2组人群体检诊断结论,调查2组年龄、体重、月经史、孕产史、分娩方式(阴道分娩者调查产程时间、有无加腹压、会阴侧切或裂伤情况)、新生儿体重、合并慢性疾病(高血压、糖尿病、慢性咳嗽、习惯性便秘、腹泻、鼻炎等等)、腹腔或盆腔手术史、初产年龄、有无子宫肌瘤或肌腺症、宫颈炎、宫颈脱垂、绝经年龄、体重指数、腰臀比、性功能等,结合全身体检出的疾病进行综合分析。数据采用单因素及多因素回归分析。结果 结果显示,多产次,使用产钳,胎吸,总产程时间≥24 h,第二产程时间≥2 h,胎儿体重过大,第二产程加腹压,产后出血,产后休息不好,高体重指数均为压力性尿失禁发生的产科危险因素,P<0.05,说明SUI病例组与对照组差异统计学意义。另外,压力性尿失禁妇女组,均有不同程度的性功能障碍。结论 压力性尿失禁的发生与妊娠,分娩中的多种产科因素相关,故提高产科质量,正确处理高危产妇尤为重要。

Objective To analyze the risk factors(especially obstetrical factors) about stress urinary incontinence (SUI) in female in Yunnan Province.Methods Medical records of 225 patients(SUI in women)admitted to the Department of Cadre's Health Check-up Center, No.2 People's Hospital of Yunnan Province between Aug. 2016 and Mar. 2017 were studied retrospectively. Meantime,we also had a retrospective study of 264 no-SUI in women. We analyzed the Health check-up diagnoses and some questions such as: age,weight,menopause pregnancy and delivery,delivery through vagina or by cesarean section,the maximum body weight of fetus, chronic desease(hypertension, diabetes mellitus,cough,constipation,et),operation in abdomen and pelvis,the quality of life and the recognition of this disease,with or without uterine myoma or adenomyoma,cervicitis,uterine prolapse, menopause age,body mass index(BMI),WHR, et. It should be combined with medical record. Data were given analysis of single factor and multiple-factor variance analysis and regression analysis . Results The incidence of SUI was higher in women with the following obstetrical factors: fecundity, obstetric forceps,fetus aspiration, total duration of labor ≥24 hours,second birth course≥two hours,higher birth weigh,using abdominal pressure in laboring, postpartum hemorrhag, poor quality of rest after delivery, larger BMI . Inaddition, women with SUI had varying degrees of sexual dysfunction. Conclusions Many risk factors(obstetric factors especially,such as pregnancy and delivery)can cause urinary ncontinence. More attention should be paid to the obsterical risk factors to improve the quality of life of SUI in women.