【作者】 沈晴；

【导师】 贺晶；

【作者基本信息】 浙江大学 ， 妇产科学， 2008， 硕士

【摘要】 目的:探讨妊娠、分娩方式以及其它相关的产科因素对女性压力性尿失禁发生的影响。方法:采用国际尿控协会(International Continence Society,ICS)推荐的国际尿失禁标准问卷,对180名在我院分娩并进行产后复查的初产妇进行问卷调查,了解其孕期及产后42天尿失禁的发病情况。分析妊娠和分娩方式与尿失禁的关系,探讨与尿失禁发生率有关的产科因素。结果:①161例产妇中有56人(34.78%)在孕期发生了尿失禁症状,有37人(22.98%)在产后4—8周内出现了尿失禁症状;产后尿失禁的发生与分娩方式、新生儿体重和产后恢复轻体力劳动的时间相关;②剖宫产、阴道顺产的尿失禁发生率分别为50%(24/48)、11.5%(13/113),两组之间有极显著性差异(P＜0.001);③阴道分娩组中与产后尿失禁有明显关系的因素有第二产程时间,而与孕周、年龄、孕期发生尿失禁、新生儿体重、会阴切开或裂伤、产后哺乳均无明显相关性。结论:①剖宫产与阴道顺产相比具有明显的保护作用,可以显著降低产后早期尿失禁的发生率:②新生儿体重增加可使产后压力性尿失禁发生的风险增加;③孕期及产后尿失禁均以轻度为主,加强孕期和产后盆底肌肉训练可以预防和治疗产后尿失禁。更多还原

【Abstract】 OBJECTIVE:To investigate the impact of pregnancy,different delivery modes and the other factors of delivery on stress urinary incontinence.METHODS:180 pnmipara,who had chuild delivery in our hospitai and were followed up 42 days after delivery,were recruited and their symptoms of stress urinary incontinence during and after pregnancy were investigated.The information of delivery was also recorded.The questionnaire was designed according to International Continence Society.As many as 161 questionnaires were valid and their data were analyzed in order to evaluate the risk factors of stress urinary incontinence.RESULTS:①56 of 161(34.78%)women complained of urinary leakage at least once during pregnancy,and 37 of 161(22.98%)women complained of urinary leakage at least once after delivery.The three factors that associated with postpartum urinary incontinence were the weight of newborn,the rest time after delivery,and the mode of delivery,but not the occurrence of urinary incontinence during pregnancy and the age.②The incidence of postpartum urinary incontinence in spontaneous vaginal delivery,and cesarean section Was 50%(24/48)and 11.5%(13/113)respectively. The incidence of urinary incontinence in spontaneous vaginal delivery Was obviously higher than that of the cesarean section(P＜0.001).③The risk factors to postpartum urinary incontinence in vaginal delivery was the duration of the second period of delive.But the outher events,such as gestational weeks,age,fetal weight,pudendal tears,episiotomy,lactation and the occurrence of urinary incontinence during. pregnant,were not correlated.CONCLUSION:①Cesarean section is obviously protective to postpartum stress urinary incontinence than vaginal delivery.②Heavy fetal weight increases the risk of postpartum stress urinary incontinence.③The symptoms of the most women with postpartum stress urinary incontinence are mild.Pelvic floor exercise during pregnancy and after delivery is valid to prevent postpartum urinary incontinence.更多还原