北京市养老院老年女性粪失禁患病率及危险因素分析

发布时间：2018-04-21 03:06

本文选题：粪失禁 + 危险因素　；参考：《山东大学》2014年硕士论文

【摘要】：研究背景粪失禁(fecal incontinence, FI)是女性盆底功能障碍性疾病的重要组成部分,并不罕见,并且常常与尿失禁(urinary incontinence, UI)、盆腔器官脱垂(pelvic organ prolapse, POP)等其他盆底功能障碍性疾病(pelvic floor dysfunction diseases, PFD)同时发生。其定义尚有争议,多数研究将其定义为曾出现过经肛门不自主地漏出固体便、液体便或气体的现象。据临床表现可将粪失禁分为被动型、急迫型和漏粪。粪便性状、肠动力、神经功能、肛门括约肌等盆底肌肉功能异常等均可导致粪失禁。粪失禁的患病率在各文献的报道中差异较大,主要与调查人群、判定标准、诊断方法等不同有关。老年人中粪失禁的患病率较高,可能与其盆底功能障碍、肠动力和认知能力下降等有关。因很多患者羞于就诊,导致了粪失禁的实际患病率被低估。粪失禁可产生诸多影响,不仅造成患者巨大的身心痛苦、生活不便、甚至人格改变,而且还给家庭和社会带来沉重负担,严重影响患者的生活质量。目的本研究调查了北京市养老院65岁及以上的老年女性,旨在研究老年女性粪失禁的患病率及相关危险因素,同时评估粪失禁对老年女性生活质量的影响。方法 1.走访北京市多家养老院,以65岁及以上的神志清楚、精神正常的老年女性为研究对象。粪失禁患者纳入标准：出现过固体便、液体便或气体从肛门不自主漏出的现象；排除标准：神经系统疾病或损伤所致粪失禁,有认知功能障碍者,有精神障碍者,老年痴呆者。研究对象均自填问卷。 2.问卷内容：调查对象的人口学资料、疾病相关因素、粪失禁严重程度及粪失禁生活质量评分(FIQL)。 3.应用SPSS16.0软件进行二元非条件logistic统计分析,采用单因素Logistic回归分析筛选危险因素,将单因素分析中P0.05的变量及文献中曾报道的危险因素代入,行多因素非条件logistic回归分析。结果共计回收有效问卷372份,其中失禁患者24例。研究对象平均年龄(74±5)岁,粪失禁患者平均病程(4.5±4.2)年。粪失禁总的患病率约为6.5%,并随年龄增长而显著增加。有70.8%(17/24)的粪失禁患者同时合并其他盆底功能障碍性疾病(包括尿失禁、盆腔脏器脱垂)。多因素分析发现,产科相关肛门括约肌损伤(OR=6.670)、合并其他盆底功能障碍性疾病(OR=5.749)、第一胎体重(OR=5.519)和生产(顺产)次数(OR=3.722)4个因素为发生粪失禁的独立危险因素。此外,由于粪失禁,患者的生活质量明显下降。结论随着我国人口老龄化,粪失禁等盆底功能障碍性疾病的发病率呈逐渐上升趋势。粪失禁虽不会威胁到患者的生命,但是严重影响其生活质量。研究其发病危险因素,可为粪失禁的预防、症状的改善提供重要依据。
[Abstract]:Research background Fecal incontinence (FII) is an important component of female pelvic floor dysfunction, and is often associated with urinary incontinence, urinary incontinence, pelvic organ prolapse organ prolapse, and other pelvic floor floor dysfunction diseases (PFDs). The definition is still controversial. Most studies have defined it as the phenomenon of involuntary leakage of solid, liquid or gas through the anus. According to clinical manifestation, fecal incontinence can be divided into passive type, urgent type and leakage type. Fecal traits, intestinal motility, nerve function, and pelvic floor muscle dysfunction, such as anal sphincter, can lead to fecal incontinence. The prevalence rate of fecal incontinence varies greatly in the reports of the literature, which is mainly related to the different populations, criteria and diagnostic methods. The higher prevalence of fecal incontinence in the elderly may be related to pelvic floor dysfunction, intestinal motility and cognitive impairment. The actual prevalence of fecal incontinence is underestimated because many patients are shy about seeing a doctor. Fecal incontinence can have many effects, which not only cause great physical and mental pain, inconvenience of life, even personality change, but also bring heavy burden to family and society, and seriously affect the quality of life of patients. Purpose The purpose of this study was to investigate the prevalence and risk factors of fecal incontinence in elderly women aged 65 and above in Beijing nursing home and to evaluate the influence of fecal incontinence on the quality of life of elderly women. Method 1. To visit several nursing homes in Beijing, elderly women aged 65 and above who are mentally conscious and mentally normal are the subjects of the study. Fecal incontinence patients included in the standard: solid stool, fluid or gas from the anal involuntary leakage phenomenon; exclusion criteria: nervous system diseases or injuries caused by fecal incontinence, cognitive impairment, mental disorders, Alzheimer's disease. The subjects were all self-filled out questionnaires. 2. Contents of the questionnaire: demographic data, disease related factors, severity of fecal incontinence and quality of life score of incontinence. 3. The binary unconditioned logistic statistical analysis was carried out by using SPSS16.0 software, and the risk factors were screened by univariate Logistic regression analysis. The variables of P0.05 in univariate analysis and the risk factors reported in the literature were added to the statistical analysis, and the multivariate unconditioned logistic regression analysis was carried out. Result A total of 372 valid questionnaires were collected, including 24 incontinence patients. The average age of the subjects was 74 卤5 years, and the mean course of disease was 4.5 卤4.2 years in patients with fecal incontinence. The total prevalence of fecal incontinence was about 6.5 and increased significantly with age. 70.8% of patients with fecal incontinence also have other pelvic floor disorders (including urinary incontinence, pelvic organ prolapse). Multivariate analysis showed that four factors, OR6.670, OR5.749, OR5.519 and OR3.722) were independent risk factors of fecal incontinence. In addition, due to fecal incontinence, the quality of life of patients significantly decreased. Conclusion With the aging of population in China, the incidence of pelvic floor disorders such as fecal incontinence is on the rise. Fecal incontinence does not threaten patients' lives, but seriously affects their quality of life. The study of its risk factors can provide an important basis for the prevention of fecal incontinence and the improvement of symptoms.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.5

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