南京市江北新区孕产妇肛周良性疾病患病现状调查-现代医学

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.

参考文献：

[1] 陈平,韩宝,周璐,等.中国居民肛肠疾病患病工作相关因素调查[J].中国公共卫生,2017,11(33):1628-1631.
[2] THOMPSON J F,ROBERTS C L,CURRIE M,et al.Prevalence and persistence of health problems after childbirth:associations with parity and method of birth[J].Birth,2002,29(2):83-94.
[3] POSKUS T,BUZINSKIEN D,DRASUTIENE D,et al.Haemorrhoids and anal fissures during pregnancy and after childbirth:a prospective cohort study[J].J Psychosom Obstet Gynaecol,2014,121(13):1666-1672.
[4] FERDINANDE K,DORREMAN Y,ROELENS K,et al.Anorectal symptoms during pregnancy and postpartum:a prospective cohort study[J].Colorectal Dis,2018,20(12):1109-1116.
[5] SCOTT R S,TRACYL H,THOMAS E R,et al.The ASCRS textbook of colon and rectal surgery[M].New York:Springer,2016:183-205.
[6] ANSARA D,COHEN M M,GALLOP R,et al.Predictors of women's physical health problems after childbirth[J].J Psychosom Obstet Gynaecol,2005,26(2):115-125.
[7] SCHYTT E,LINDMARK G,WALDENSTROM U.Physical symptom safter childbirth:prevalence and associations with self-rated health[J].J Psychosom Obstet Gynaecol,2005,112(2):210-217.
[8] MACARTHUR C,LEWIS M,KNOX E G.Health after childbirth[J].J Psychosom Obstet Gynaecol,1991,98(12):1193-1204.
[9] 符春平,班文芬,王娴,等.贵州省黔南地区妊娠妇女肛肠疾病的患病现状及其危险因素[J].中国妇幼保健,2016,31(6):1245-1248.
[10] 张威.浙江省390例妊娠妇女肛肠疾病的患病现状及其危险因素分析[J].中国妇幼保健,2018,33(6):1385-1388.
[11] ABRAMOWITZ L,SOBHANI I,BENIFLA J L,et al.Anal fissure and thrombosed external hemorrhoids before and after delivery[J].Dis Colon Rectum,2002,45(5):650-655.
[12] 赵艳,王英娟,刘静.积极心理学干预结合膳食调节对便秘型肠易激综合征患者的影响[J].现代医学,2019,47(11):1427-1432.
[13] 汤琳琳,陈坚,王雅萍.膳食评估微信平台在肥胖孕妇营养干预中的应用[J].现代医学,2019,47(5):517-521.

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