盆底康复治疗患者的分布及变化趋势分析:一项基于3033例患者的研究  

Distribution and Trends of Patients Undergoing Pelvic Floor Rehabilitation:A Study Based on 3033 Patients

作　　者：吴纯华 刘娟[1] WU Chunhua;LIU Juan(Department of Obstetrics and Gynecology,Guangdong Provincial Key Laboratory of Major Obstetric Diseases,Guangdong Provincial Clinical Research Center For Obstetrics and Gynecology,Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510150,China)

机构地区：[1]广州医科大学附属第三医院妇产科、广东省产科重大疾病重点实验室、广东省妇产疾病临床医学研究中心、粤港澳母胎医学高校联合实验室,广东广州510150

出　　处：《实用妇产科杂志》2024年第8期639-644,共6页Journal of Practical Obstetrics and Gynecology

基　　金：国家自然科学基金项目(编号:NO.81671440);广州地区临床高新、重大、特色技术(编号:2023C-TS42)。

摘　　要：目的:分析接受盆底康复治疗患者的分布及变化特征,探讨其有临床症状的相关影响因素、就诊特征。方法:对2010年1月至2019年12月广州医科大学附属第三医院接受盆底康复治疗患者的年龄、分娩方式、产次、治疗时间等数据进行回顾性分析。结果:①接受盆底康复治疗患者共3033例,无临床症状者72.8%(2209/3033),近十年呈下降趋势(P=0.000);有临床症状者27.2%(824/3033),呈上升趋势(P=0.000),8类临床症状中尿失禁症状的比例为72.5%(597/824)。②十年间盆底康复治疗患者中,40岁以上患者比例逐年增加(P=0.001);③经阴道分娩的妇女所占比例最高(70.3%),近十年趋势保持平稳(P=0.054)。④十年间盆底康复治疗患者中初产妇占比最高(73.1%),经产妇(产次≥2)的患者有增高趋势(P=0.000);⑤84.8%(2573/3033)患者进行盆底康复治疗距离末次分娩时间<1年,治疗距离末次分娩时间≥1年的患者呈增多的趋势(P=0.002,r=0.855)。⑥年龄≥40岁(OR 10.884,P<0.001)、孕次为3次(OR 1.634,P=0.001)、孕次≥4次(OR 1.908,P<0.001)、产次为2次(OR 1.305,P=0.038)、产次≥3次(OR 2.327,P=0.001)、经阴道分娩(OR 2.079,P<0.001)是已生育接受盆底康复治疗患者有临床症状的独立危险因素。结论:接受盆底康复治疗有临床症状患者中,以尿失禁症状为主,呈增加的趋势;强化对年龄≥40岁、有阴道分娩史、孕次≥3次、产次≥2次的女性早期筛查和干预,对年龄≥40岁、距离末次分娩≥1年的女性可考虑将治疗时间前移。Objective:The distribution and change characteristics of patients undergoing pelvic floor rehabilitation treatment were analyzed,the related influencing factors of patients with clinical symptoms and the characteristics of patients seeking treatment were preliminarily discussed.Methods:A retrospective analysis was conducted on the age,delivery mode,delivery times,treatment time and other data of patients(target population)who received pelvic floor rehabilitation treatment in the Third Affiliated Hospital of Guangzhou Medical University from January 2010 to December 2019.Results:①There were 3033 cases in the target population,72.8%(2209/3033)without clinical symptoms,showing a downward trend(P=0.000);The number of patients with clinical symptoms was 27.2%(824/3033),showing an increasing trend(P=0.000).Urinary incontinence accounted for 72.5%(597/824)of the eight categories.②In the past 10 years,the proportion of patients over 40 years old increased year by year(P=0.001).③The proportion of women giving birth through vagina was the highest(70.3%)and remained stable(P=0.054).④The proportion of first-time mothers was the highest(73.1%),and the number of patients with birth rate≥2 showed an increasing trend(P=0.000);⑤84.8%(2573/3033)patients received pelvic floor rehabilitation treatment less than 1 year before the last delivery,and the treatment time more than 1 year before the last delivery showed an increasing trend(P=0.002,r=0.855).⑥Age≥40 years old(OR 10.884,P<0.001),3 pregnancies(OR 1.634,P=0.001),4 pregnancies(OR 1.908,P<0.001),2 births(OR 1.305,P=0.038),3 births(OR 2.327,P=0.001),vaginal delivery(OR 2.079,P<0.001)were risk factors for patients undergoing pelvic floor rehabilitation treatment.Conclusions:Urinary incontinence was the main symptom in patients with clinical symptoms after pelvic floor rehabilitation treatment,which showed an increasing trend.To strengthen early screening and intervention for women aged≥40 years,with a history of vaginal delivery,≥3 times of pregnancy and≥2 tim

关 键 词：女性盆底功能障碍性疾病 盆底康复治疗 临床特点 

分 类 号：R711.2[医药卫生—妇产科学]