北京市社区围绝经期及绝经后妇女泌尿生殖道及盆底功能障碍性疾病的相关因素分析

发布时间：2018-03-08 15:45

本文选题：围绝经期泌尿生殖道综合征　切入点：盆腔器官脱垂　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:调查北京市社区中老年妇女绝经期泌尿生殖道症状及盆底功能障碍(pelvic floor dysfunction,PFD)的患病情况及其危险因素。方法:本研究选择2014年10月-2014年12月在北京市第二医院及月坛社区卫生服务中心所辖范围内35岁-70岁的女性进行调查。问卷内容包括一般情况、文化程度、职业、月收入、体质指数(body mass index,BMI)、月经、分娩方式及妇科手术等情况。采用盆底功能障碍问卷短表(pelvic floor distress inventory-short form 20,PFDI-20)对PFD情况进行调查。参与调查的妇女均进行妇科检查,明确是否患有盆底器官脱垂(pelvic organ prolapse,POP)。被调查者均为自愿参加并签署知情同意书。采用SPSS19.0软件进行数据统计分析,采用二分类多因素回归分析方法分析PFD和POP患者患病的危险因素。结果:1一般情况:对3000人进行调查,有效问卷2791份,有效应答率93.0%。平均年龄为(53.61±7.06)岁,平均绝经年龄为49.92±3.61岁。2萎缩性阴道炎的患病率:萎缩性阴道炎的患病率是31.351%(875/2791),其95%可信区间是0.2963-0.3307。阴道疼痛的患病率是8.205%(229/2791),性交痛患病率15.514%(433/2791),阴道瘙痒19.527%(545/2791),阴道局部烧灼感患病率7.847%(219/2791)。3萎缩性阴道炎与绝经的关系:围绝经期萎缩性阴道阴道炎的患病率为3.296%(92/2791),绝经期萎缩性阴道炎的患病率为19.025%(531/2791)。绝经期中萎缩性阴道炎症状患病率高于围绝经期者。4 PFD的患病率:盆底功能障碍的患病率为64.314%(1795/2791),其95%可信区间(95%CI)为:0.3391-0.3746。5 PFD与分娩方式的关系:阴道分娩者PFD患病率为67.455%(1283/1902),剖宫产者PFD患病率为58.309%(400/686)。阴道分娩者PFD患病率高于剖宫产者,差异有统计学意义(X2 18.546,P0.05)。6 PFD发生的危险因素:围绝经期OR:2.266 95%CI 1.173-4.379;躯体疾病OR:2.142 95%CI 1.456-3.151;应用更年期药物OR:2.711 95%CI1.668-4.405;高中及中等学校教育OR:0.435 95%CI 0.271-0.699;患有萎缩性阴道炎OR:2.701 95%CI 1.743-4.186。7 POP与分娩方式的关系:子宫脱垂、阴道前壁脱垂和阴道后壁脱垂的患病率分别为2.735%(75/2742)、11.233%(308/2742)、4.850%(133/2742),阴道分娩组及剖宫产组POP病率分别为14.507%(272/1875)和9.3%(63/674),两组比较差异有统计学意义(X2 11.562,P0.05)。8 POP发生的危险因素:如果将35-44岁POP女性的OR值定为1.0,则45-54岁OR:2.601 95%CI 1.403-4.821;55-64岁OR:2.826 95%CI1.531-5.217;如果正常体重OR值为1.0,那么超重OR:1.725 95%CI1.195-2.490;肥胖OR:3.612 95%CI 2.221-5.875;同样,剖宫产OR值定为1.0,则顺产OR:2.342 95%CI 1.574-3.483;妇科手术OR:2.45895%CI1.275-4.740;患有妇科疾病OR:3.350 95%CI 1.479-7.589。结论:1萎缩性阴道炎的发生与绝经有关;2 PFD的发生与月经情况、分娩次数、躯体疾病、更年期药物应用情况、学历、萎缩性阴道炎有关;3 POP的发生与年龄、BMI、分娩方式、妇科手术情况、学历、妇科疾病有关。
[Abstract]:Objective: to investigate the prevalence and risk factors of urogenital symptoms and pelvic floor dysfunction (floor dysfunctional PFDs) in middle-aged and elderly women in Beijing from October 2014 to December 2014. A survey was conducted among women aged 35 to 70 years under the jurisdiction of the Community Health Service Center in the hospital and the Moon Temple. The questionnaire included general information. Education level, occupation, monthly income, body mass index (BMI), menstruation, mode of delivery and gynecologic operation were investigated by using pelvic floor floor distress inventory-short form 20PFDI-20. To determine whether or not the pelvic floor organ prolapse organ prolapse Pop. The participants were willing to participate and sign the informed consent. The data were analyzed by SPSS19.0 software. Two classification multivariate regression analysis was used to analyze the risk factors of PFD and POP patients. Results: the average age was 53.61 卤7.06 years, the average age was 53.61 卤7.06 years, the average age was 53.61 卤7.06 years. The average menopausal age was 49.92 卤3.61 years old. 2 prevalence of atrophic vaginitis: atrophic vaginitis was 31.351and 875 / 2791, with a 95% confidence interval of 0.2963-0.3307.The prevalence of vaginal pain was 8.20555 / 2791m, the prevalence of coitus pain was 15.51414 / 433 / 2791, the vaginal pruritus 19.52727545 / 2791, the vaginal burning sensation of local vagina was 0.2963-0.33071.The prevalence of coitus pain was 15.51414% 433 / 2791, and the vaginal pruritus was 19.5272745% 2791%. The prevalence rate of atrophic vaginitis and menopause is 7.847 7 / 2791%: the prevalence rate of atrophic vaginitis is 3.296% / 2791%, and that of menopausal atrophic vaginitis is 19.02525% 53 1 / 2791%. The prevalence of atrophic vaginitis in menopause is higher than that in peri-menopausal period. The prevalence of atrophic vaginitis in menopause is higher than that in peri-menopausal period. The prevalence of atrophic vaginitis in menopause is higher than that in perimenopause. The prevalence of PFD: the prevalence rate of pelvic floor dysfunction was 64.31414% 1795 / 2791, and its 95% CI was 0.3391-0.3746.5 PFD. The prevalence of PFD in vaginal delivery was 67.45553 / 1902, and the prevalence of PFD in caesarean section was 58.309400 / 6860.The prevalence of PFD in vaginal delivery was higher than that in caesarean section. The risk factors of OR:2.266 95CI 1.173-4.379; somatic disease OR:2.142 95CI 1.456-3.151; menopausal drug OR:2.711 95CI 1.668-4.405; high school and secondary school education OR:0.435 95 CI 0.271-0.699; OR:2.701 95CI 1.743-4.186.7 POP with atrophic vaginitis. Type of relationship: uterine prolapse, The prevalence of prolapse of anterior vaginal wall and posterior wall of vagina were 2.7355.75 / 2742 / 11.233 / 3082742 / 4.8500.133 / 2742, respectively, and the rates of POP's disease in vaginal delivery group and cesarean section were 14.5072 / 1875) and 9.363 / 674, respectively. There were significant differences between the two groups in the risk factors of POP: if we take the 35-44 year old POP female as the risk factor: if you take the 35-44 year old POP female, the incidence of POP's disease is 14.5072% 1875% and 9.363 3% 674% respectively. There is a significant difference between the two groups in the risk factors of POP. If the OR value of sex is 1.0, then OR:2.601 95CI 1.403-4.82155-64 years old OR:2.826 95CI1.531-5.217; if the OR value of normal body weight is 1.0, then overweight OR:1.725 95CI1.195-2.490; obese OR:3.612 95CI 2.221-5.875; similarly, If the OR value of cesarean section is 1.0, then OR:2.342 95CI 1.574-3.483, OR: 2.45895CI1.275-4.740; OR:3.350 95 CI 1.479-7.589.Conclusion the occurrence of atrophic vaginitis is related to the occurrence and menstruation of menopause, the times of delivery, the body disease and the application of menopausal drugs. Education, atrophic vaginitis related to the occurrence of 3 POP related to age, delivery, gynecological surgery, education, gynecological diseases.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.5;R691.5

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