妊娠晚期膀胱过度活动症孕妇合并压力性尿失禁危险因素及困扰程度

Risk Factors and Distress Degree of Stress Urinary Incontinence in Pregnant Women with Overactive Bladder in the Third Trimester

摘要: 目的：探讨分析妊娠晚期膀胱过度活动症孕妇发生压力性尿失禁的困扰程度及影响因素，以期为制定有效的护理干预策略提供依据。方法：本研究采用方便随机抽样法选取于2024年6月至2024年9月在吴起县人民医院和延安市安塞区人民医院妇产科住院部或门诊部就诊的患者作为调查对象，选用一般资料调查表、OAB症状评分量表(OABSS)、国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)、Zung焦虑、抑郁自评量表(SAS、SDS)进行调查。一般资料中计数资料用频数与构成比((n)%)来描述，计量资料符合正态分布采用($\overline{X}\pm s$ )描述；组间比较采用c²检验或t检验，c²检验或t检验分析妊娠晚期膀胱过度活动症孕妇发生压力性尿失禁在一般资料和疾病相关资料上的差异，二元Logistic回归分析妊娠晚期膀胱过度活动症孕妇发生压力性尿失禁的危险因素，以P < 0.05有统计学差异。结果：本研究共纳入138例妊娠晚期孕妇，其中存在膀胱过度活动症的孕妇55例，占到39.9%，存在不同程度压力性尿失禁的孕妇79例，占57.2%，妊娠晚期膀胱过度活动症孕妇合并压力性尿失禁的孕妇有45例，占32.6%；妊娠晚期膀胱过度活动症孕妇发生压力性尿失禁的风险是无膀胱过度活动症孕妇6.485倍；膀胱过度活动症孕妇压力性尿失禁量表总得分为(9.60 ± 3.31)分，OAB症状总得分为(7.60 ± 2.26)分，轻度OAB孕妇8例(17.8%)，中度OAB孕妇35例(77.8%)，尿失禁问卷表中中度29例(64.4%)，占比最大；二元Logistic回归分析，结果显示：孕周(OR = 1.115)、运动量/日(OR = 0.176)、盆底肌力(OR = 0.0.423)进入方程，具有统计学意义(P < 0.05)。结论：妊娠晚期膀胱过度活动症孕妇合并压力性尿失禁发生较频繁、程度较重，孕周是妊娠晚期膀胱过度活动症孕妇合并压力性尿失禁的危险因素，而运动量/日、盆底肌力(级)是膀胱过度活动症孕妇合并压力性尿失禁的保护因素。临床中针对受膀胱过度活动症合并压力性尿失禁不同困扰程度的孕晚期孕妇采取有效护理措施及积极的心理指导。

Abstract: Objective: To explore and analyze the distress degree and influencing factors of stress urinary incontinence in pregnant women with overactive bladder in the third trimester, in order to provide basis for formulating effective nursing intervention strategies. Method: In this study, convenient random sampling method was adopted to select patients who visited the inpatient department or outpatient department of Obstetrics and Gynecology in Wuqi County People’s Hospital and Ansai District People’s Hospital of Yan’an City from June 2024 to September 2024 as the investigation objects, and general data questionnaire, OAB Symptom Score Scale (OABSS), and Summary of Incontinence Questionnaire of the International Urinary Incontinence Advisory Committee (ICI-Q-SF), Zung Anxiety and Depression Self-Rating Scale (SAS, SDS) was investigated. In general data, counting data were described by frequency and component ratio ((n) %), and measurement data conforming to normal distribution were described by ($\overline{X}\pm s$ ); Comparison between groups was conducted using γ² test or T-test to analyze the differences between general and disease-related data on stress urinary incontinence in pregnant women with overactive bladder in the third trimester. Binary Logistic regression analysis was performed to analyze the risk factors of stress incontinence in pregnant women with overactive bladder in the third trimester of pregnancy, and P < 0.05 was statistically significant. Results: A total of 138 pregnant women in the third trimester were included in this study, including 55 pregnant women with overactive bladder, accounting for 39.9%, 79 pregnant women with different degrees of stress incontinence, accounting for 57.2%, 45 pregnant women with overactive bladder combined with stress incontinence in the third trimester, accounting for 32.6%. The risk of stress incontinence in pregnant women with overactive bladder in the third trimester was 6.485 times than that of pregnant women without overactive bladder. The total score of stress incontinence scale of pregnant women with overactive bladder was (9.60 ± 3.31) points, and the total score of OAB symptoms was (7.60 ± 2.26) points. There were 8 cases (17.8%) of mild OAB pregnant women, 35 cases (77.8%) of moderate OAB pregnant women, and 29 cases (64.4%) of moderate incontinence questionnaires, accounting for the largest proportion. Binary Logistic regression analysis showed that: gestational week (OR = 1.115), exercise amount/day (OR = 0.176), and pelvic floor muscle strength (OR = 0.0.423) entered the equation, with statistical significance (P < 0.05). Conclusion: The frequency and severity of stress incontinence in pregnant women with overactive bladder in the third trimester are the risk factors for stress incontinence in pregnant women with overactive bladder in the third trimester, while the amount of exercise/day and pelvic floor muscle strength (grade) are the protective factors for stress incontinence. In clinic, effective nursing measures and positive psychological guidance were taken for pregnant women with different distress degrees of overactive bladder combined with stress urinary incontinence.