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南京市江北新区孕产妇肛周良性疾病患病现状调查
作者:侯孝涛1  陈艳妮1  曹悦3  马文娟2  陈浩1  沈伟1  于正霞2  沈秀红2  姚永畅2  王凤英2  秦美霞2 
单位:1. 东南大学附属中大医院江北院区/原南京市大厂医院 肛肠科, 江苏 南京 210048;
2. 东南大学附属中大医院 江北院区/原南京市大厂医院 妇产科, 江苏 南京 210048;
3. 南京市六合妇幼保健所 计划生育科, 江苏 南京 211500
关键词:肛周良性疾病 孕产妇 患病现状 危险因素 
分类号:R266
出版年·卷·期(页码):2020·48·第十一期(1377-1380)
摘要:

目的:探讨南京市江北新区孕产妇肛周常见良性疾病的发病率及相关危险因素。方法:随机抽取2019年3月至2020年2月在南京市江北新区三级甲等综合医院就诊的孕产妇500例为研究对象,460例孕产妇完成病例观察。根据孕产妇患有肛周良性疾病者及肛周不适的情况,将研究随访的孕产妇分为2组,患有肛周良性疾病者为观察组和未发生肛周疾病者为对照组。采用SPSS 25.0统计软件进行统计分析,对可能影响孕产妇肛周良性疾病患病率的相关因素作多因素Logistic回归分析。结果:271例(58.91%)孕产妇有肛周疾病症状,其中肛周疾病发生在妊娠早中期44例(16.24%),122例(45.02%)出现在妊娠晚期,100例(36.9%)出现在生产时或产后立即出现,产褥期5例(1.09%)。187例(69%)考虑为痔病,29例(10.7%)为肛裂,26例(9.6%)为肛门湿疹及分泌物增多,24例(8.9%)为肛门坠胀、刺痛不适,3例(1.1%)为肛瘘,2例(0.7%)为肛乳头瘤。采用多因素Logistic回归分析显示:既往有肛周疾病史、妊娠期便秘、新生儿体重>3.8 kg、第二产程持续时间>20 min、孕周>39周,有统计学意义(P<0.05)。结论:肛周良性疾病在妊娠晚期和分娩时易于发生,妊娠期便秘、肛周疾病史、孕周>39周、新生儿体重>3.8 kg、第二产程持续时间>20 min是孕产妇发生肛周疾病的重要危险因素。

Objective: To identify the incidence and risk factors of perianal diseases on pregnant and puerperal womenin Nanjing Jiangbei new area. Methods: 500 consecutive pregnant women invited to enter the study from March 2019 to February 2020. 460 women agreed to participate in the study during their pregnancy until puerperium were included. The women were divided into two groups: women in one group had developed the perianal disease, the other group had not. All significant univariate risk factors were included in a multiple Logistic regression model to identify independent risk factors. Calculations were performed using the statistical software package SPSS, version 25. Results: In all, 271(58.91%) women developed perianal disease, 44(16.24%) in the first trimester, 122(45.02%) during the last trimester, 100(36.9 %) after delivery and 5(1.09%) until puerperium; 187(69%) women were diagnosed with haemorrhoids, 29(10.7%) with anal fissure, 26(9.6%) with anal eczema and secretion increase, 24(8.9%) with rectal distension and tingling discomfort, 3(1.1%) with anal fistula, 2(0.7%) with anal papilloma. Multivariate analysis identified constipation, personal history of perianal diseases, late birth after 39 weeks of pregnancy, birthweight of newborn>3.8 kg, and straining during delivery for more than 20 minutes as significant predictors of benign perianal disease during pregnancy and perinatal period(P<0.05). Conclusion: Perianal benign diseases are common during the last trimester of pregnancy and childbirth, with constipation, personal history of perianal diseases, birthweight of newborn>3.8 kg, straining during delivery for more than 20 minutes being independently associated risk factors.

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