初产妇产后早期盆底功能状况及压力性尿失禁影响因素分析

Analysis of postpartum early pelvic floor function status in primiparas and its influencing factors of stress urinary incontinence

  • 摘要:
      目的  探讨初产妇产后早期盆底功能状况,分析产后早期压力性尿失禁影响因素。
      方法  选取行盆底功能障碍性疾病筛查的811例初产妇为研究对象。收集产妇筛查结果及可能影响产后早期压力性尿失禁的因素,根据有无产后压力性尿失禁将产妇分为早期压力性尿失禁组71例,无早期压力性尿失禁组740例。比较2组上述各因素,采用多因素Logistic回归分析确定初产妇产后早期压力性尿失禁的影响因素。
      结果  811例产妇中出现早期盆底功能障碍132例(16.28%),其中压力性尿失禁71例(8.75%),盆底脏器脱垂43例(5.30%),膀胱颈移位18例(2.22%)。年龄增大、孕前体质量指数(BMI)增加、孕期尿失禁、会阴侧切、新生儿体质量增加及第二产程时间延长为初产妇产后早期压力性尿失禁的危险因素,剖宫产及孕期缩肛训练为保护性因素(P < 0.05)。
      结论  初产妇产后早期盆底功能障碍发生率较高,以压力性尿失禁为主。本地区初产妇压力性尿失禁与产妇年龄、孕前BMI等因素有关,临床可进行针对性干预,以降低其产后早期压力性尿失禁发生率。

     

    Abstract:
      Objective  To investigate the early pelvic floor function of primiparas in postpartum period, and to analyze the influencing factors of early postpartum stress urinary incontinence.
      Methods  A total of 811 primiparas who underwent screening for pelvic floor dysfunction were selected as the research subjects. The results of maternal screening and the factors that might affect early postpartum stress urinary incontinence were collected. According to whether postpartum stress urinary incontinence was present or not, the puerperas were divided into early stress urinary incontinence group (n=71) and no early stress urinary incontinence group (n=740). The above factors were compared between the two groups, and multivariate Logistic regression was used to analyze the related influencing factors of early postpartum stress urinary incontinence in primiparas.
      Results  Among 811 parturients, 132 cases (16.28%) had early pelvic floor dysfunction, including 71 cases (8.75%) of stress urinary incontinence, 43 cases (5.30%) of pelvic floor organ prolapse, and 18 cases (2.22%) of bladder neck displacement. Older age, pre-pregnancy body mass index (BMI) increase, pregnancy urinary incontinence, perineal lateral resection, neonatal body weight increase and prolonged time of the second stage of labor were the risk factors for early postpartum stress urinary incontinence of primiparas, cesarean section and pregnancy rectus training were the protective factors (P < 0.05).
      Conclusion  The incidence of pelvic floor dysfunction in the early postpartum period is high in the primary parturients, mainly causing stress urinary incontinence. The stress urinary incontinence of primiparas in this area is related to maternal age, pre-pregnancy BMI and other factors, and targeted intervention can be carried out clinically in order to reduce the incidence of early stress urinary incontinence after delivery.

     

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