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Received:November 20, 2020 Published Online:July 20, 2021
Received:November 20, 2020 Published Online:July 20, 2021
中文摘要: 目的系统评价我国女性发生压力性尿失禁(SUI)的危险因素。方法计算机检索PubMed、Web of Science、The Cochrane Library、Clinicalkey、中国知网、维普、万方、中国生物医学数据库,搜集我国女性发生SUI危险因素的病例-对照研究、队列研究及横断面研究,检索时限均从建库至2020年5月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入35个研究,包括94 043例研究对象,涉及20个危险因素。Meta分析结果显示,年龄增加[OR=2.39,95%CI(2.02~2.82)]、劳动强度大[OR=1.48,95%CI(1.30~1.69)]、BMI高[OR=1.61,95%CI(1.44~1.81)]、饮酒史[OR=1.38,95%CI(1.25~1.53)]、高血压[OR=1.68,95%CI(1.35~2.08)]、便秘[OR=1.62,95%CI(1.46~1.80)]、呼吸系统病史[OR=2.46,95%CI(2.15~2.81)]、泌尿系统病史[OR=2.31,95%CI(1.90~2.80)]、妇科疾病史[OR=3.02,95%CI(1.35~6.72)]、孕次多[OR=1.33~95%CI(1.08~1.63)]、产次(≥3次)[OR=1.53,95%CI(1.39~1.68)]、第一胎胎儿体重大[OR=2.10,95%CI(1.13~3.91)]、会阴裂伤[OR=1.51,95%CI(1.32~1.73)]、阴道分娩[OR=1.91,95%CI(1.55~2.36)]、绝经[OR=1.80,95%CI(1.48~2.19)]、盆腔手术史[OR=2.15,95%CI(1.47~3.15)]、子宫脱垂[OR=2.21,95%CI(1.68~2.91)]均是我国女性发生SUI的危险因素(P<0.05,P<0.01),剖宫产[OR=0.71,95%CI(0.51~0.97),P=0.03]是我国女性SUI的保护因素(P<0.01)。结论年龄增加、BMI高、劳动强度大、饮酒史、高血压、便秘、呼吸系统疾病史、泌尿系统疾病史、妇科疾病史、孕次多、产次(≥3次)、第一胎胎儿体重大、会阴裂伤、阴道分娩、绝经、盆腔手术史、子宫脱垂是我国女性SUI的危险因素,而剖宫产是中国女性SUI的保护因素。对具有以上危险因素的高危患者应加强防护,采取适当的干预措施,以期减少女性SUI的发生,提高女性患者的生活质量。
Abstract:Objective To systematically evaluate the risk factors of stress urinary incontinence (SUI) in Chinese women.
Methods The electronic databases of PubMed,Web of Science,Cochrane Library,Clinicalkey,CNKI,VIP,WanFang Data and SinoMed were searched to collect case control studies,cohort studies and cross sectional studies on risk factors of SUI in Chinese women.The retrieval time was from the establishment of each database to May 2020.After two researchers independently screened the literature,extracted the data and assessed the risk of bias in included studies,Meta analysis was performed by Revman 5.3 software.
Results Thirty five studies involving 94 043 participants were included,and 20 potential risk factors were eventually evaluated.Meta analysis showed that the following factors were risk factors of female SUI in China,including increasing age [OR=2.39,95%CI (2.02-2.82)],higher labor intensity [OR=1.48,95%CI (1.30-1.69)],higher BMI [OR=1.61,95%CI (1.44-1.81)],history of alcohol consumption [OR=1.38,95%CI (1.25-1.53)],hypertension [OR=1.68,95%CI (1.35-2.08)],constipation [OR=1.62,95%CI(1.46-1.80)],history of respiratory diseases [OR=2.46,95%CI (2.15-2.81)],urinary system diseases [OR=2.31,95%CI(1.90-2.80)],gynecological diseases [OR=3.02,95%CI (1.35-6.72)],more times of pregnancy [OR=1.33,95%CI (1.08-1.63)],bearing birth more than three times [OR=1.53,95%CI (1.39-1.68)],heavier birth weight of the first born child [OR=2.10,95%CI(1.13-3.91)],perineal lacerations[OR=1.51,95%CI(1.32-1.73)],vaginal delivery [OR=1.91,95%CI (1.55-2.36)],menopause [OR=1.80,95%CI (1.48-2.19)],history of pelvic surgery [OR=2.15,95%CI (1.47-3.15),uterine prolapse [OR=2.21,95%CI (1.68-2.91)](P<0.05,P<0.01).Cesarean section was a protective factor for SUI in Chinese women[OR=0.71,95%CI(0.51-0.97),P=0.03].
Conclusions Increaing age,higher BMI,higher labor intensity,history of drinking,higher blood pressure,constipation,history of respiratory diseases,history of urinary system diseases,history of gynecological diseases,more pregnancy times,birth times (≥3 times),first baby′s birth weight,perineum laceration,vaginal delivery,menopause,history of pelvic surgery,and uterine prolapse are risk factors for SUI in Chinese women,while cesarean section is a protective factor for SUI in Chinese women.For the high risk female patients with the above risk factors of SUI,protection should be strengthened and appropriate intervention measures should be taken in order to reduce the incidence of SUI and improve the life quality of them.
文章编号: 中图分类号:R694+.54 文献标志码:A
基金项目:新疆生产建设兵团科技攻关项目(2018AB023)
Author Name | Affiliation |
WANG Yuan-yi,XUAN Liu-ming,WANG Qin-zhang | Department of Urology Surgery,First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi,Xinjiang 832000,China |
Author Name | Affiliation |
WANG Yuan-yi,XUAN Liu-ming,WANG Qin-zhang | Department of Urology Surgery,First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi,Xinjiang 832000,China |
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