产后妇女盆底功能障碍状况及其影响因素  

Status of pelvic floor dysfunction and its influencing factors in postpartum women

作　　者：杜亚飞[1] 陈然[1] 刘晶[1] 房桂英[1] 王旭[1] 

机构地区：[1]河北医科大学第一医院妇产科,石家庄050030

出　　处：《检验医学与临床》2018年第3期289-292,共4页Laboratory Medicine and Clinic

基　　金：国家卫生和计划生育委员会医药卫生科技项目(13010520140632);河北省医学科学研究重点课题项目(ZL20140306)

摘　　要：目的研究产后妇女盆底功能障碍(PFD)发生情况及其影响因素。方法选取2015年6月至2016年6月产后42d行产后复查的产妇1 280例,向产妇发放基本资料调查问卷并进行盆底肌力筛查。分析该地区产妇产后PFD发生情况。采用单因素及Logistic多因素分析影响产后PFD发生情况的相关因素。结果1 280例产妇中PFD发生率为9.37%。其中,年龄≥35岁产妇PFD比例高于年龄<35岁产妇;阴道分娩产妇PFD发生率高于剖宫产产妇;产次>2次产妇PFD发生率高于产次≤2次产妇;产前体质量指数(BMI)>23kg/m2的产妇PFD发生率高于BMI≤23kg/m2的产妇;有糖尿病史产妇PFD发生率高于非糖尿病史产妇;有便秘史产妇PFD发生率高于非便秘史产妇;会阴Ⅱ度裂伤产妇PFD发生率高于Ⅰ度裂伤产妇;新生儿体质量≥3.5kg的产妇PFD发生率高于新生儿体质量<3.5kg的产妇;转化生长因子-β(TGF-β)阴性产妇PFD发生率高于TGF-β阳性产妇;纤维蛋白-5(fibulin-5)阴性产妇PFD发生率高于fibulin-5阳性产妇;孕期行盆底肌功能锻炼产妇PFD发生率低于未行盆底肌功能锻炼产妇。经Logistic多因素分析显示,阴道分娩、产次>2次、新生儿体质量≥3.5kg、会阴Ⅱ度裂伤、TGF-β阴性、fibulin-5阴性是PFD发生的独立危险因素,孕期行盆底肌功能锻炼是PFD的保护因素。结论产后妇女PFD发生率较高,可能与盆底组织中TGF-β、fibulin-5表达异常有关。Objective To study the incidence and influencing factors of pelvic floor dysfunction(PFD)in postpartum women.Methods A total of 1 280 maternal postnatal follow-ups were performed 42 days postpartum from June 2015 to June 2016.Basic questionnaire was sent to the women and pelvic floor muscle strength screening was performed.The incidence of postpartum PFD in this area was analyzed.The single factor and Logistic factors were used to analyze the related factors that affected the postpartum PFD.Results The incidence of PFD among 1 280 cases was 9.37%.Among them,the proportion of PFDs of women≥35 year of age was higher than that of women<35 years of age.The incidence of PFD in vaginal delivery was higher than in cesarean delivery.>2 births had a higher rate of PFD than those ≤2 births.Prenatal body mass index(BMI)>23 kg/m2 PFD incidence was higher than those with BMI≤23 kg/m2.The incidence of PFD among women with a history of diabetes was higher than that of women without a history of diabetes.The incidence of PFD in those with constipation was higher than those in non-constipation.The incidence of PFD in women with perinealⅡlaceration was higher than that in women with degree I laceration.The incidence of PFD in women who′s newborns≥3.5 kg was higher than that in newborns<3.5 kg.The incidence of PFD in TGF-β-negative women was higher than that in TGF-β-positive women.The incidence of PFD in fibulin-5-negative women was higher than in fibulin-5-positive women.Prenatal pelvic floor muscle function training maternal PFD incidence was lower than those who did not exercise pelvic floor muscle function of women.Logistic multivariate analysis showed that vaginal delivery,delivery times>2,neonatal body weight≥3.5 kg,perineal laceration,TGF-β-negative,fibulin-5-negative were independent risk factors for PFD and pelvic floor muscle exercise during pregnancy was aprotective factor of PFD.Conclusion Postpartum women have a higher incidence of PFD,which might be related to the abnormal expression of TGF-βand fib

关 键 词：妇女 盆底功能障碍 调查 影响因素 

分 类 号：R711[医药卫生—妇产科学]