JAMA：美近四份之一妇女患有盆腔疾病

发布者：EurekAlert!中文版 发布时间：2008-9-22

　　据9月17日《美国医学协会期刊》（JAMA）上的一则研究披露，在对妇女的调查中，有近1/4的人以及有超过1/3的老年妇女报告说，她们患有至少一种盆腔功能失调症，其中包括尿失禁和大便失禁以及盆腔器官的移位。这些疾病随着年龄和体重的增加而变得更为普遍。

　　盆腔疾病包括尿失禁和粪便失禁、盆腔器官脱垂（即某一盆腔器官，如子宫，从其正常的位置脱垂到其它位置并对阴道壁造成挤压）。

　　美国犹他大学医学院的Ingrid Nygaard及其同事开展了一项研究，旨在评估女性中有症状的盆腔功能失调症的流行情况。

　　研究人员发现，总的来说，有23.7%的妇女报告患有至少一种盆腔功能失调症。在这些人中，15.7%的人经历过尿失禁、9.0%的人经历过大便失禁，而2.9%的人经历过盆腔器官脱垂的症状。报告患有至少一种盆腔疾病的妇女的比例随着年龄的增长而增加。

　　妇女所生的孩子数量越多，至少罹患一种盆腔功能失调的可能性也越大。盆腔功能失调症与族裔／种族和教育水平之间没有明显的相关性。

JAMA，300(11):1311-1316，Ingrid Nygaard，Debra J. Brody

Prevalence of Symptomatic Pelvic Floor Disorders in US Women

Ingrid Nygaard, MD, MS; Matthew D. Barber, MD, MHS; Kathryn L. Burgio, PhD; Kimberly Kenton, MD, MS; Susan Meikle, MD, MSPH; Joseph Schaffer, MD; Cathie Spino, DSc; William E. Whitehead, PhD; Jennifer Wu, MD, MPH; Debra J. Brody, MPH; for the Pelvic Floor Disorders Network

Context  Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect many women. No national prevalence estimates derived from the same population-based sample exists for multiple pelvic floor disorders in women in the United States.

Objective  To provide national prevalence estimates of symptomatic pelvic floor disorders in US women.

Design, Setting, and Participants  A cross-sectional analysis of 1961 nonpregnant women (20 years) who participated in the 2005-2006 National Health and Nutrition Examination Survey, a nationally representative survey of the US noninstitutionalized population. Women were interviewed in their homes and then underwent standardized physical examinations in a mobile examination center. Urinary incontinence (score of 3 on a validated incontinence severity index, constituting moderate to severe leakage), fecal incontinence (at least monthly leakage of solid, liquid, or mucous stool), and pelvic organ prolapse (seeing/feeling a bulge in or outside the vagina) symptoms were assessed.

Main Outcome Measures  Weighted prevalence estimates of urinary incontinence, fecal incontinence, and pelvic organ prolapse symptoms.

Results  The weighted prevalence of at least 1 pelvic floor disorder was 23.7% (95% confidence interval [CI], 21.2%-26.2%), with 15.7% of women (95% CI, 13.2%-18.2%) experiencing urinary incontinence, 9.0% of women (95% CI, 7.3%-10.7%) experiencing fecal incontinence, and 2.9% of women (95% CI, 2.1%-3.7%) experiencing pelvic organ prolapse. The proportion of women reporting at least 1 disorder increased incrementally with age, ranging from 9.7% (95% CI, 7.8%-11.7%) in women between ages 20 and 39 years to 49.7% (95% CI, 40.3%-59.1%) in those aged 80 years or older (P < .001), and parity (12.8% [95% CI, 9.0%-16.6%], 18.4% [95% CI, 12.9%-23.9%], 24.6% [95% CI, 19.5%-29.8%], and 32.4% [95% CI, 27.8%-37.1%] for 0, 1, 2, and 3 or more deliveries, respectively; P < .001). Overweight and obese women were more likely to report at least 1 pelvic floor disorder than normal weight women (26.3% [95% CI, 21.7%-30.9%], 30.4% [95% CI, 25.8%-35.0%], and 15.1% [95% CI, 11.6%-18.7%], respectively; P < .001). We detected no differences in prevalence by racial/ethnic group.

Conclusion  Pelvic floor disorders affect a substantial proportion of women and increase with age.