發(fā)布時間：2018-03-08 15:45

  本文選題：圍絕經(jīng)期泌尿生殖道綜合征　切入點：盆腔器官脫垂　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:調(diào)查北京市社區(qū)中老年婦女絕經(jīng)期泌尿生殖道癥狀及盆底功能障礙(pelvic floor dysfunction,PFD)的患病情況及其危險因素。方法:本研究選擇2014年10月-2014年12月在北京市第二醫(yī)院及月壇社區(qū)衛(wèi)生服務(wù)中心所轄范圍內(nèi)35歲-70歲的女性進(jìn)行調(diào)查。問卷內(nèi)容包括一般情況、文化程度、職業(yè)、月收入、體質(zhì)指數(shù)(body mass index,BMI)、月經(jīng)、分娩方式及婦科手術(shù)等情況。采用盆底功能障礙問卷短表(pelvic floor distress inventory-short form 20,PFDI-20)對PFD情況進(jìn)行調(diào)查。參與調(diào)查的婦女均進(jìn)行婦科檢查,明確是否患有盆底器官脫垂(pelvic organ prolapse,POP)。被調(diào)查者均為自愿參加并簽署知情同意書。采用SPSS19.0軟件進(jìn)行數(shù)據(jù)統(tǒng)計分析,采用二分類多因素回歸分析方法分析PFD和POP患者患病的危險因素。結(jié)果:1一般情況:對3000人進(jìn)行調(diào)查,有效問卷2791份,有效應(yīng)答率93.0%。平均年齡為(53.61±7.06)歲,平均絕經(jīng)年齡為49.92±3.61歲。2萎縮性陰道炎的患病率:萎縮性陰道炎的患病率是31.351%(875/2791),其95%可信區(qū)間是0.2963-0.3307。陰道疼痛的患病率是8.205%(229/2791),性交痛患病率15.514%(433/2791),陰道瘙癢19.527%(545/2791),陰道局部燒灼感患病率7.847%(219/2791)。3萎縮性陰道炎與絕經(jīng)的關(guān)系:圍絕經(jīng)期萎縮性陰道陰道炎的患病率為3.296%(92/2791),絕經(jīng)期萎縮性陰道炎的患病率為19.025%(531/2791)。絕經(jīng)期中萎縮性陰道炎癥狀患病率高于圍絕經(jīng)期者。4 PFD的患病率:盆底功能障礙的患病率為64.314%(1795/2791),其95%可信區(qū)間(95%CI)為:0.3391-0.3746。5 PFD與分娩方式的關(guān)系:陰道分娩者PFD患病率為67.455%(1283/1902),剖宮產(chǎn)者PFD患病率為58.309%(400/686)。陰道分娩者PFD患病率高于剖宮產(chǎn)者,差異有統(tǒng)計學(xué)意義(X2 18.546,P0.05)。6 PFD發(fā)生的危險因素:圍絕經(jīng)期OR:2.266 95%CI 1.173-4.379;軀體疾病OR:2.142 95%CI 1.456-3.151;應(yīng)用更年期藥物OR:2.711 95%CI1.668-4.405;高中及中等學(xué)校教育OR:0.435 95%CI 0.271-0.699;患有萎縮性陰道炎OR:2.701 95%CI 1.743-4.186。7 POP與分娩方式的關(guān)系:子宮脫垂、陰道前壁脫垂和陰道后壁脫垂的患病率分別為2.735%(75/2742)、11.233%(308/2742)、4.850%(133/2742),陰道分娩組及剖宮產(chǎn)組POP病率分別為14.507%(272/1875)和9.3%(63/674),兩組比較差異有統(tǒng)計學(xué)意義(X2 11.562,P0.05)。8 POP發(fā)生的危險因素:如果將35-44歲POP女性的OR值定為1.0,則45-54歲OR:2.601 95%CI 1.403-4.821;55-64歲OR:2.826 95%CI1.531-5.217;如果正常體重OR值為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;同樣,剖宮產(chǎn)OR值定為1.0,則順產(chǎn)OR:2.342 95%CI 1.574-3.483;婦科手術(shù)OR:2.45895%CI1.275-4.740;患有婦科疾病OR:3.350 95%CI 1.479-7.589。結(jié)論:1萎縮性陰道炎的發(fā)生與絕經(jīng)有關(guān);2 PFD的發(fā)生與月經(jīng)情況、分娩次數(shù)、軀體疾病、更年期藥物應(yīng)用情況、學(xué)歷、萎縮性陰道炎有關(guān);3 POP的發(fā)生與年齡、BMI、分娩方式、婦科手術(shù)情況、學(xué)歷、婦科疾病有關(guān)。
[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 鹵7.06 years, the average age was 53.61 鹵7.06 years, the average age was 53.61 鹵7.06 years. The average menopausal age was 49.92 鹵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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.5;R691.5

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