分娩时肛门括约肌破裂18年后的女性健康：I. 大便失禁
Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence.
作者信息
Faltin Daniel L, Otero Maria, Petignat Patrick, Sangalli Michel R, Floris Lucia A, Boulvain Michel, Irion Olivier
机构信息
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
出版信息
Am J Obstet Gynecol. 2006 May;194(5):1255-9. doi: 10.1016/j.ajog.2005.10.797. Epub 2006 Apr 21.
OBJECTIVE
We studied the long-term outcome after an anal sphincter tear.
STUDY DESIGN
From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7%) who sustained a sphincter tear and 445 controls. Eighteen years after the delivery, we mailed them a questionnaire and graded fecal incontinence with the Wexner score, a summary of incontinence to flatus, liquid, or solid stools; need to wear a pad; and lifestyle alterations. We predefined severe incontinence as a score above 4 of 20.
RESULTS
Five hundred forty of 890 women (61%) returned the questionnaire. Severe fecal incontinence was reported by 34 of 259 women (13.1%) after a sphincter tear and 22 of 281 controls (7.8%) (risk ratio 1.7, 95% confidence interval 1.0 to 2.8). Only 6.4% of the reports of fecal incontinence were attributable to a sphincter tear.
CONCLUSION
Fecal incontinence is frequently reported, even by women who have not sustained an anal sphincter tear. Only a small fraction of fecal incontinence can be attributed to sphincter tears.
目的
我们研究了肛门括约肌撕裂后的长期预后情况。
研究设计
从1982年至1983年分娩的4569名女性队列中，我们确定了445名（9.7%）发生括约肌撕裂的女性以及445名对照者。分娩18年后，我们给她们邮寄了一份问卷，并使用韦克斯纳评分对大便失禁进行分级，该评分总结了对排气、液体或固体粪便失禁的情况；是否需要使用护垫；以及生活方式的改变。我们将严重失禁预先定义为评分高于20分中的4分。
结果
890名女性中有540名（61%）回复了问卷。括约肌撕裂后，259名女性中有34名（13.1%）报告有严重大便失禁，281名对照者中有22名（7.8%）（风险比1.7，95%置信区间1.0至2.8）。只有6.4%的大便失禁报告可归因于括约肌撕裂。
结论
即使是没有发生肛门括约肌撕裂的女性，也经常报告有大便失禁。只有一小部分大便失禁可归因于括约肌撕裂。
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