4～5岁儿童功能性遗粪症流行病学与危险因素研究

Epidemiology of functional encopresis among children aged 4 - 5 years in Qingdao

目的了解青岛市城区4～5岁儿童功能性遗粪症的流行情况、诊疗状况和影响因素。方法应用分层随机整群抽样的方法，采用问卷调查和专科随访相结合的方式，调查分析4～5岁儿童功能性遗粪症的患病情况、诊疗状况及影响因素。结果（1）流行病学：4～5岁儿童功能性遗粪症的患病率为2．23％，其中男童患病率为1．46％，女童患病率为3．14％，女童患病率高于男童（Х^2=12．946，P〈0．01）。90例患儿中偶尔发生者占82．22％，经常发生者占17．78％。90例患儿曾就诊者仅8例（就诊率为8．89％），治疗时间均不足1年，且效果不佳。（2）影响因素：多因素非条件logistic回归分析显示女性、大家庭、入园前保姆或机构照看、非头胎、儿童早产、儿童遗尿、儿童便秘、父亲遗粪史、母亲遗尿史（OR=2．064，0．354，0．613，2．551，3．729，3．235，5．450，11．066，13．314）是功能性遗粪症发生的影响因素。结论功能性遗粪症的患病率大大高于临床医师的估计，就诊率低；女性、非头胎、儿童早产、儿童遗尿、儿童便秘、父亲遗粪史和母亲遗尿史是4—5岁儿童功能性遗粪症发生的危险因素。

Objective To examine the epidemiologic features, medical visit situations of functional encopresis in children aged 4 - 5 years in urban areas of Qingdao, and analyze the related factors of functional encopresis. Methods A population-based questionnaire study was conducted among subjects 4-5 years of age sampled from kindergartens in Qingdao and subjects were followed up. 4044 children aged 4 -5 years（ male 2196, female 1848） were chosen by stratified-clustered-random sampling. The prevalence, and the related factors of functional encopresis were investigated by self-made general condition and factors influencing encopresis questionnaire. Parents were asked to fill questionnaires. Results （ 1 ） The prevalence： 4044 out of 4135 parents of children respond to the questionnaire. The morbidity rate of functional eneopresis of children aged 4 - 5 years was 2.23% , of the total 1.46% males, 3.14% females, the prevalence of female much more than that of male（ Х^2 = 12.946, P〈 0.01 ）. Those who soil occasionally were found in 82.22%. Only 8.89% of the 4 - 5 years old who had eneopresis had ever been taken to see a doctor for this problem. （ 2 ） Data from logistic regression analyses indicated female, large family, care of nurse or organization before entering kindergarten, non-first-fetus, preterm children, children enuresis, constipation of children, paternal encopresis, and maternal enuresis （ OR = 2. 064, 0. 354, 0. 613, 2.551, 3. 729, 3. 235, 5. 450, 11. 066, 13.314） affected the occurrence of functional eneopresis. Conclusion The actual morbidity rate of functional eneopresis was much more than estimation of clinical doctors and most of ehildren with functional encopresis didn＇t visit doctor. Female, non-first-fetus, preterm ehildren, children enuresis, constipation of children, paternal eneopresis, and matemal enuresis were risk factors of functional eneopresis.