天津市蓟县农村老年人尿失禁患病率及相关因素分析

Study on the prevalence of urinary incontinence and its related factors among elderly in rural areas, Jixian county, Tianjin

目的探讨天津市蓟县农村老年人尿失禁的患病情况及主要相关因素。方法采用整群抽样方法抽取天津市蓟县所辖的两个乡（镇）卫生院60岁及以上老年人743名，以面对面询问的方式进行入户调查，对可能与尿失禁有关的因素分别进行单因素及多因素logistic回归分析，寻找老年人尿失禁的相关因素。结果老年人尿失禁患病率为33．38％，与老年男性尿失禁患病风险增加相关的因素包括高龄（0R=1．39）、脑力劳动（OR=5．00）、听说过尿失禁（OR=1．91）、患呼吸系统疾病（OR=2．23）、患神经系统疾病（OR-=11．76）、患前列腺疾病（OR=11．47）、患运动系统疾病（OR=2．48）。与老年男性尿失禁患病风险降低相关的因素为文化程度高（以小学及以下文化程度为对照水平，初中组OR=0．35，高中或中专组OR=0．77，大专或大学本科OR=0．53）。与老年女性尿失禁患病风险增加相关的因素包括高龄（OR=1．31）、便秘（OR=1．46）、听说过尿失禁（OR=1．94）、超重及肥胖（以正常组为对照水平，超重组OR=1．03，肥胖组OR=1．54）、患呼吸系统疾病（OR=4．84）、患运动系统疾病（OR=1．37）、患糖尿病（OR=2．36）、孕次多（0R=1．03）、产次多（OR=1．02）、分娩时发生会阴裂伤（OR=1．72）、伤口感染（OR=1．65）。与老年女性尿失禁患病风险降低相关的因素为经常参加体育锻炼（OR=0．64）。结论天津市蓟县农村老年人尿失禁患病率较高，老年人尿失禁的发生与多种因素有关。

Objective To understand the prevalence of urinary incontinence （UI） and its related factors so as to develop a three-tier program for prevention of the disease. Methods A cross-sectional study was carried out in two townships of Jixian county, Tianjin, during July to November 2007. A total of 743 people aged 60 years and over were selected under cluster sampling, and all information were collected with a standardized structured questionnaire by face-to-face interview. All the data were analyzed with multivariate logistic regression method to explore the related factors for UI in the elderly. Results The overall prevalence of UI was 33.38 percent among people aged 60 years and over in two townships. Risk factors for UI in men would include older age （OR=1.39）, occupation （OR=5.00）, awareness ofUI（OR=1.91）, having in chronic respiratory diseases （OR=2.23）, prostate （OR=11.47）, neurological （OR=11.76）, or motor systems （OR= 2.48）, while protective factors would include high educational level （taking primary school or below as control group） , OR for the junior middle school group appeared to be 0.35, for senior middle school group it was 0.77, and of undergraduate group it was 0.53. Risk factors for UI in women would include older age （OR= 1.31 ）, constipation （OR= 1.46）, awareness of UI （OR= 1.94）, increased body mass index （when normal weight group served as control group, OR in the overweight group was 1.03 and in the obesity group OR was 1.54）, suffering from chronic respiratory diseases （OR= 4.84）, diabetes mellitus （OR=2.36）, or motor system diseases （OR= 1.37）, more gravidity （OR= 1.03 ）, more parity （OR= 1.02）, suffering from perinea laceration （OR= 1.72） and wound infection during delivery （OR= 1.65） , while protective factors would include physical exercises （OR=0.64）. Conclusion Prevalence of UI was higher among the elderly people in rural areas of Jixian county, Tianjin. UI in the elderly might have been influenced by various factors which suggesting the intervention strategy should be targeted at those related factors as well as focusing on primary prevention.