CAJ | 학술논문

目的：探讨妊娠和分娩及产科相关因素对女性产后压力性尿失禁的影响。方法应用经会阴超声成像技术，测量94例初产妇产后6～8周膀胱颈活动度及尿道旋转角度，与30例未孕妇女行对照研究，分析妊娠和产科相关因素对压力性尿失禁的影响。结果94例入选产妇中阴道分娩组50例，剖宫产组44例，两组年龄、分娩孕周、新生儿出生体重无明显差异（P＞0．05），而产前体重指数有统计学意义（P＜0．05）。产后6周阴道分娩组有15例（30％）发生过压力性尿失禁（SUI），而剖宫产组有4例（9．1％），有统计学差异（P＜0．05）。阴道分娩组、剖宫产组及未孕妇女两两相比，膀胱颈活动度及尿道旋转角度均有统计学差异（P＜0．05）。Logistic回归分析显示阴道分娩、产前有SUI、产钳助产及会阴撕裂是产后压力性尿失禁的危险因素。结论妊娠和分娩是压力性尿失禁的危险因素，与剖宫产相比，阴道分娩增加产后压力性尿失禁的发生率。
목적：탐토임신화분면급산과상관인소대녀성산후압력성뇨실금적영향。방법응용경회음초성성상기술，측량94례초산부산후6～8주방광경활동도급뇨도선전각도，여30례미잉부녀행대조연구，분석임신화산과상관인소대압력성뇨실금적영향。결과94례입선산부중음도분면조50례，부궁산조44례，량조년령、분면잉주、신생인출생체중무명현차이（P＞0．05），이산전체중지수유통계학의의（P＜0．05）。산후6주음도분면조유15례（30％）발생과압력성뇨실금（SUI），이부궁산조유4례（9．1％），유통계학차이（P＜0．05）。음도분면조、부궁산조급미잉부녀량량상비，방광경활동도급뇨도선전각도균유통계학차이（P＜0．05）。Logistic회귀분석현시음도분면、산전유SUI、산겸조산급회음시렬시산후압력성뇨실금적위험인소。결론임신화분면시압력성뇨실금적위험인소，여부궁산상비，음도분면증가산후압력성뇨실금적발생솔。
Objective This study was conducted to investigate the influence of pregnancy,delivery and associated obstetric factors on fe-male postpartum stress urinary incontinence.Methods Compared the bladder neck mobility and urethral rotation angle of 94 primiparas in 6 to 8 weeks after post partum with those of 30 nulliparas by translabial ultrasound,and analyzed the association of pregnancy,childbirth and related obstetric factors with stress urinary incontinence.Results All 94 primiparas were divided into two groups:50 in the vaginal delivery (VD)group and 44 in the caesarean section (CS )group.There was no statistically significant difference between the two groups in terms of age,delivery week and birth weight (P>0.05),but the antenatal body mass index(BMI)showed statistically signif-icant difference between the two groups (P<0.05).The prevalence of SUI in VD group was 15 out of 50(30%),which is significantly different from the CS group with 4 out of44 (9.1%)(P<0.05).The bladder neck mobility and urethral rotation angle are significantly different among VD,CS and nulliparous group(All P<0.05).Logistic regression analysis showed that SUI was strongly associated with vaginal delivery,SUI during pregnancy,forceps delivery and perineal lesion(P<0.05).Conclusions Pregnancy and delivery are risk factors for stress urinary incontinence.Vaginal delivery increases the risks of postpartum SUI compared with cesarean section.