产后妇女漏尿症状及影响因素分析

Status and influencing factors of urine leakage in postpartum women

目的调查产后妇女发生漏尿症状的现状并分析其影响因素,为预防和积极干预提供参考。方法采用便利抽样法,收集717例产后42~60 d复查的妇女的一般资料,测量产后盆底功能及评估产后漏尿情况。结果717例产后妇女中,出现漏尿症状130例,发生率为18.13%。单因素分析结果显示,年龄、阴道分娩次数、分娩方式、妊娠期漏尿、生殖裂孔长度、Ⅰ类肌力、Ⅱ类肌力以及POP-Q分期与妇女产后出现漏尿症状有关(P<0.05,P<0.01);Logistic回归分析显示,年龄、顺产、产钳助产、Ⅰ类肌力和妊娠期漏尿是产后妇女发生漏尿症状的影响因素(P<0.05,P<0.01)。结论产后42~60 d妇女的漏尿患病率处于较高水平,年龄增大、顺产及产钳助产、I类肌力减弱和妊娠期漏尿可增加产后出现漏尿症状的概率,临床医护人员应早期给予积极干预,以降低产后漏尿的发生率。

Objective To investigate the current situation of urine leakage symptoms in postpartum women,to explore the influencing factors of postpartum urine leakage,and to provide basis for prevention and early evaluation of urine leakage symptoms.Methods Convenience sampling method was used to collect the demographic data,pelvic function data,and postpartum urine leakage data from 717 women(42-60 postpartum days)who visited the outpatient department of Peking University People's Hospital for postpartum review from February through December 2019.Results Among the 717 postpartum women,130 had symptoms of urine leakage,with an incidence rate of 18.13%.The results of univariate analysis showed that such 8 factors as age,number of vaginal delivery,mode of delivery,urine leakage during pregnancy,genital hiatus(gh)measurements,strength of type Ⅰ&Ⅱ pelvic floor muscle,and stage of POP-Q,were associated with postpartum urine leakage(P<0.05,P<0.01).Logistic regression analysis showed that age,vaginal delivery,forceps delivery,type Ⅰ muscle strength and urine leakage during pregnancy were determinants of postpartum urine leakage(P<0.05,P<0.01).Conclusion The prevalence rate of urine leakage in postpartum 42-60 days is at a high level,and increased age,vaginal and forceps delivery,weakened strength of type I muscle and urine leakage during pregnancy increase the probability of postpartum urine leakage.Clinical medical staff should assess and screen these influencing factors early on in order to reduce the incidence of postpartum urine leakage.