首页|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

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

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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。
Distribution and Trends of Patients Undergoing Pelvic Floor Rehabilitation:A Study Based on 3033 Patients
Objective:The distribution and change characteristics of patients undergoing pelvic floor rehabilita-tion treatment were analyzed,the related influencing factors of patients with clinical symptoms and the characteris-tics 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 re-ceived 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 in-creasing trend.To strengthen early screening and intervention for women aged ≥40 years,with a history of vagi-nal delivery,≥3 times of pregnancy and≥2 times of birth,for women aged≥40 years and more than 1 year from the last delivery,the treatment time should be moved forward.

Female pelvic floor functional disordersPelvic floor rehabilitation treatmentClinical characteristics

吴纯华、刘娟

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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

女性盆底功能障碍性疾病 盆底康复治疗 临床特点

国家自然科学基金项目广州地区临床高新、重大、特色技术

816714402023C-TS42

2024

实用妇产科杂志
四川省医学会

实用妇产科杂志

CSTPCD北大核心
影响因子:2.564
ISSN:1003-6946
年,卷(期):2024.40(8)