146例压力性尿失禁患者的发病相关因素分析  

Study on risk factors of 146 gynecological outpatients with stress urinary incontinence

作　　者：文建国[1] 王庆伟[1] 冯晓丹[1] 魏振玲[1] 刘奎[1] 

机构地区：[1]河南省郑州大学第一附属医院尿动力学中心,妇产科和海南省临床医学重点学科开放实验室,450052

出　　处：《中国妇产科临床杂志》2007年第4期259-262,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：河南省高校杰出科研人才创新工程项目(2001KYCX004);河南省杰出人才创新基金(0221002000);国家自然科学基金(30571931)资助

摘　　要：目的对妇产科门诊压力性尿失禁（stress urinary incontinence，SUI）患者进行压力性尿失禁发病相关因素分析。方法对2005年1月~2005年2月在河南省郑州大学第一附属医院妇产科门诊进行B超检查的2500例体检者抽样调查349例，对其中发现的146例SUI患者进行相关因素分析。其中27例进行膀胱尿道B超影像检查。结果无明显器质性病变患者103例中，女性SUI发病率随年龄增加而增加，在14-20岁、21-40岁、40-87岁三个年龄阶段，SUI发病率分别为12.5%（1/8）、20.8%（10/48）、76.6%（36/47），三者比较显著性差异（P=0.000）。60例已生育患者（45.0±10.7）岁受检者中，经阴道顺产54例，发现SUI36例，占66.7%（36/54），剖宫产6例，仅发现1例SUI，占16.7%（1/6），两者相比差异有显著性（P〈0.027）。64例生育一胎的受检者中，SUI的发病率为37.5%（24/64），41例生育两胎或以上者，SUI的发病率为58.5%（24/41），而70例未生育患者中，SUI的发病率为4.3%（3/70），三者的差别具有统计学意义（P=0.000）。11例子宫脱垂患者全都有SUI。27例尿失禁患者进行了经阴道B超检查，发现16例（59.3%）膀胱充盈后膀胱颈口呈漏斗形改变。结论女性SUI发病率随着年龄的增长而增加；多种妇产科因素如经阴道分娩、多产和子宫脱垂等都与女性SUI密切相关。B超影像学检查可以为正确评估女性SUI提供客观依据。Objective To analyze the risk factors associated with stress urinary incontinence （SUI） in outpatient of gynecological clinics. Methods From January to July 2005, 349 women were randomly investigated from 2500 women who came to the outpatient clinic for physical examination, and 146 patients were found with SUI. The possible gynecological and obstetrical factors that related to SUI were analyzed. Transvaginal B ultrasound was performed in 27 women with severe SUI to see the thickness of bladder wall and morphology of bladder neck. Results The prevalence of SUIin different age groups （14-20）, （21-40） and （40-87） years old, was 12.5% （1/8）, 20.8% （10/48） and 76.6% （36/47）, respectively, with significant difference among age groups （P=0. 000）. In the 60 women who had given birth, aged （45.0± 10.7） yrs, 36 （66.7%） out of 54, who had vaginal childbirth, were found with SUI and only 1 （16.7%） in 6 patients who had Cesarean section, with significant difference （P= 0.027）. The SUI were found in 37.5% （24/64）, 58.5% （24/41） and 4.3% （3/70） of patients who had one, two or more and none babies, respectively. The difference was significant （P=0. 000）. Eleven cases, aged （53. 8±10. 9） yrs, with uterus prolapse were all with SUI. The funneling of bladder neck were observed in 59.3% （16/27） of SUI cases. Conclusions The prevalence of female SUI in gynecological outpatients increased with age and significant related to vaginal childbirth, uterus prolepses and pelvic operation. Transvaginal B ultrasound examination is a useful tool to evaluate female SUI.

关 键 词：女性 压力性尿失禁 相关因素 

分 类 号：R694[医药卫生—泌尿科学]