摘要
目的分析经产妇产后早期(6～8周)压力性尿失禁(Stress urinary incontinence, SUI)的临床危险因素。方法回顾性分析于北京大学第三医院2016年1月至2017年10月分娩及产后复查的141例经产妇临床资料,依据尿失禁简表(ICIQ-UI)确诊SUI 81例,非SUI即对照组60例,比较两组的相关危险因素。结果单因素分析显示,与非SUI组相比,经产妇产后早期SUI组的前次阴道分娩和末次阴道分娩比例明显升高(63.2%vs 36.8%,P=0.016;63.3%vs 36.7%,P=0.009)。前次阴道分娩合并会阴侧切和会阴裂伤经产妇发生产后早期SUI比例升高(66.1%vs 33.9%,P=0.014;76.2%vs 23.8%,P=0.009)。末次阴道分娩无会阴侧切或裂伤、合并会阴侧切、合并会阴裂伤三种情况的经产妇产后早期SUI是末次剖宫产分娩的1.6倍、2.0倍以及1.7倍(RR:1.594,P=0.095;RR:1.939,P=0.043;RR:1.723,P=0.014)。末次妊娠时年龄、孕前体质指数、孕期体重增加、新生儿体重、妊娠期糖尿病等因素,在两组之间差异均无统计学意义(P>0.05)。多因素分析显示,末次阴道分娩是经产妇产后早期SUI的独立危险因素(OR=2.939 95%CI:1.232～7.009,P=0.015)。结论末次分娩方式为阴道分娩的经产妇发生产后早期SUI风险明显增加,并及时给予指导和必要的干预。
Objective To evaluate the clinical risk factors of stress urinary incontinence(SUI) 6-8 weeks after delivery in multipara. Methods A retrospective study was used to obtain 141 multipara who have their delivery and subsequent visit in Peking university Third hospital from Jan 2016 to Oct 2017. All of the cases were divided into two groups according to ICIQ-UI, 81 cases with SUI and 60 cases without SUI. The clinical risk factors were compared between the two groups. Result Compared with non-SUI group, the composition of vaginal delivery in previous and latest delivery were higher in SUI group(63.2% vs 36.8%,P =0.016;63.3% vs 36.7%, P =0.009). The risks of early SUI in woman who had vaginal delivery preciously with episiotomy or perineal tear were increased(66.1% vs 33.9%, P=0.014;76.2% vs 23.8%, P=0.009). The risks of early SUI in woman without episiotomy or perineal tear in the latest vaginal delivery were increased 1.6 times compared with woman with latest caesarean delivery(RR 1.594, P =0.095).For episiotomy and perineal tear, the risks were 2.0 times(RR 1.939, P =0.043) and 1.7 times(RR 1.723, P =0.014). There were no difference in the age of last pregnancy, body mass index before pregnancy, weight gain during pregnancy, newborn weight and diabetes mellitus between two groups(P > 0.05). Multivariate analysis showed vaginal delivery was an independent risk factor of developing early SUI(OR=2.939 95% CI :1.232 ~ 7.009, P =0.015). Conclusion Multipara with vaginal delivery need to take more care about early postpartum SUI and should seek for intervention when necessary.
作者
王晓晔
钟若忻
王姸
江元慧
葛霖
WANG Xiaoye;ZHONG Ruoxin;WANG Yan;JIANG Yuanhui;GE Lin(Departement of obstetrics and Gynecology,Peking Universi(y Third Hospital,Beijing 100191,China)
出处
《中国妇产科临床杂志》
CSCD
北大核心
2019年第1期25-27,共3页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
国家重点研发计划(2016YFC1000400)
关键词
压力性尿失禁
经产妇
阴道分娩
危险因素
stress urinary incontinence
multipara
vaginal delivery
risk factors
