盆腔器官脱垂377例分析

目的:探讨盆腔器官脱垂(POP)发病人群的特点。方法:回顾性分析377例盆腔器官脱垂患者的发病年龄、与绝经时间的关系、合并症等情况。分析较年轻患者(<40岁)生产次数及产钳助产史,并与≥40岁患者产钳助产史发生率进行比较。结果:除1例无孕产史,其余均有阴道分娩史,平均产次3.65次。绝经后发病率明显增高,占62.60%,绝经后20年内发病率最高,50～69岁为高发年龄。合并慢性咳嗽及过敏性鼻炎史13例,合并糖尿病22例,有甲状腺功能亢进史15例,全子宫切除后阴道壁膨出12例。<40岁发病年轻患者产次1～3次的18例,4～8次的48例,其中家中分娩者15例,有6例合并会阴Ⅲ度裂伤。<40岁发病年轻患者66例中有产钳助产史者11例,≥40岁发病311例中产钳助产史者11例(P<0.01),两组比较有非常显著性差异。结论:盆腔器官脱垂绝大多数应是复合病因造成。绝经后妇女、阴道分娩经产妇为盆腔器官脱垂高发病人群,较年轻发病妇女(<40岁)多产及有不良生产史者为易发病人群。合并有代谢性疾病及反复增加腹压疾病者盆腔器官脱垂风险增加。

Analalysis of 377 patients with pelvic organ prolapse

Objective:To discuss characteristic of patients with pelvic organ prolapse(POP).Methods:317 in-patients with POP were reviewed about their age,menopause,complications etc to compare the times of delivery and history of forceps delivery between the young(<40 years old)and the older(≥40 years old).Results:All patients had history of vaginal delivery expect one case without pregnant history.The average times of delivery was 3.65.Incidence of POP after menopause was increased,which was 60.3%.And incidence of POP in 20 years after menopause was the highest and 50~70 years was high-incidence age.13 patients of 377 combinated with chronic cough and allergic rhinitis,22 patients with diabetes,15 patients with hyperthyroidism,12 patients with vaginal wall prolapse after hysterectomy.18 patients <40 years had 1~3 times of delivery,48 patients had 4~8 times of delivery.And 15 patients had home delivery,of which 6 patients were combinated with Ⅲ° perineal laceration.11 patients with history of forceps delivery were in 66 patients <40 years and 11 patients with history of forceps delivery were in 311 patients ≥40 years,which two groups had significant difference.Conclusion:The etiology of POP is muti-factor.Women after menopause and with several vaginal delivery are people with high-incidence of POP.The younger patients with several delivery and bad production are proned to POP.Patients' risk of POP,combinated with metabolic disease and disease of increased abdominal pressure,is increased.