子宫内膜异位症术后尿失禁的相关危险因素分析

目的 探讨子宫内膜异位症(EMs)术后尿失禁的相关危险因素。方法 选择2016年1月—2019年5月在本院行腹腔镜手术治疗的360例EMs患者,无尿失禁334例,出现尿失禁26例。收集患者临床资料,分析尿失禁发生危险因素。结果 尿失禁组合并高血压、体质指数(BMI)≥25 kg/m2、尿失禁病史、合并糖尿病、术后腹压增加、并发尿路感染、阴道前后壁膨出、30 d内行重体力劳动的比率以及年龄、术后留置尿管时间均高于无尿失禁组,差异有统计学意义(P<0.05)。Logistic回归分析显示,合并高血压、BMI≥25 kg/m2、合并糖尿病、术后腹压增加、术后30 d内行重体力劳动、年龄≥35岁是EMs术后尿失禁发生的独立危险因素(P<0.05且OR>1)。结论 合并高血压、BMI≥25 kg/m2、合并糖尿病、术后腹压增加、术后30 d内行重体力劳动、年龄≥35岁是EMs术后尿失禁发生的独立危险因素,临床应结合上述危险因素,实施针对性的防治措施,以改善患者预后。

Analysis of risk factors associated with postoperative urinary incontinence in endometriosis

Objective To investigate the risk factors of urinary incontinence after endometriosis (EMs) surgery. Methods A total of 360 patients with EMs who underwent laparoscopic surgery in a hospital from January 2016 to May 2019 were enrolled. There were 334 patients without urinary incontinence and 26 patients with urinary incontinence. The clinical data of the patients enrolled were collected and the risk factors of urinary incontinence were analyzed. Results The proportions of urinary incontinence combined with hypertension, body mass index (BMI)≥25 kg/m2, history of urinary incontinence, diabetes, increased postoperative abdominal pressure, complicated urinary tract infection, anterior and posterior vaginal wall bulging, heavy physical labor within 30 days, age, and the postoperative indwelling catheter time in the urinary incontinence group were higher/longer than those in the no urinary incontinence group (P<0.05). The logistic regression analysis showed that hypertension, BMI≥25 kg/m2, diabetes mellitus, postoperative abdominal pressure increased, heavy physical labor within 30 days after surgery, and age≥35 years were independent risk factors for urinary incontinence after EMs (P<0.05 and OR>1). Conclusion Hypertension, BMI≥25 kg/m2, diabetes mellitus, increased postoperative abdominal pressure, heavy physical labor within 30 days after surgery, and age≥35 years were independent risk factors of urinary incontinence after Ems (P<0.05, and OR>1). Therefore, in clinic, we should combine the above risk factors to implement the targeted prevention measures in order to improve patient prognosis.