产后慢性泌尿生殖疼痛的危险因素分析

Analysis of risk factors for chronic urogenital pain after childbirth

目的探讨产后慢性泌尿生殖疼痛(chronic urogenital pain,CUP)相关性盆底肌损伤的主要危险因素。方法选取2018年5月至2020年4月产后42 d至6个月于我院盆底康复中心行产后随访并诊断为CUP的患者120例为研究对象(CUP组),以同期来我院行产后随访无盆底功能障碍性疾病的妇女100例为对照组。对所有研究对象进行问卷调查,并检测两组研究对象的肌力等级,记录研究对象临床资料,运用统计学软件对CUP可能的影响因素进行分析,探讨导致产后CUP的主要危险因素。结果研究期间本院产后CUP的发生率为15.03%(1587/10561)。CUP组的盆底肌肌力显著弱于对照组(P<0.05)。单因素分析显示,CUP组的新生儿体重以及巨大儿比例均显著高于对照组(P<0.05);CUP组经产妇、阴道分娩、长期姿势不良、慢性便秘的比例均显著高于对照组(P<0.05)。多因素Logistic回归分析发现,巨大儿、阴道分娩、长期姿势不良、慢性便秘均为产后CUP的影响因素(P<0.05)。结论产后CUP发生率较高,临床应控制孕期胎儿体重,注意会阴缝合技术,纠正孕期及产后慢性便秘、矫正不良姿势,以降低产后CUP的发生率。

Objective:To explore the main risk factors of postpartum chronic urogenital pain(CUP)related pelvic floor muscle injury.Methods:A total of 120 patients with postpartum follow-up and diagnosed as CUP in pelvic floor rehabilitation center of our hospital from May 2018 to April 2020 were selected as the research objects(CUP group),and 100 women without pelvic floor dysfunction disease who came to our hospital for postpartum follow-up in the same period were selected as the control group.All the patients were investigated by questionnaire,and the muscle strength grade of the two groups was detected,and the clinical data of the patients were recorded.The possible influencing factors of CUP were analyzed by statistical software to explore the main risk factors of postpartum CUP.Results:The incident of postpartum of CUP was 15.03%(1587/10561).The pelvic muscle strength of patients with CUP was significant weaker than that of the control group(P<0.05).Univariate analysis showed that the neonatal weight and the proportion of macrosomia of the CUP group were significantly higher than that of the control group(P<0.05).The proportions of multipara,vaginal delivery,long-term poor posture,chronic constipation in CUP group were significantly higher than that in the control group(P<0.05).The multivariate logistic regression analysis showed that macrosomia,vaginal delivery,long-term poor posture and chronic constipation were the influencing factors of postpartum CUP(P<0.05).Conclusions:The incidence of postpartum of chronic urogenital pain is higher.In order to reduce the incidence of postpartum CUP,the clinicians should control the fetal weight during pregnancy,pay attention to perineum suture technique,correct chronic constipation during pregnancy and postpartum,and correct bad posture.