妇科门诊患者尿失禁情况调查

Investigation of urinary incontinence among outpatients of the gynecological department

目的初步分析武汉大学人民医院妇科门诊中尿失禁患者的流行病学特征及影响就诊的因素。方法通过现场访谈和发放调查问卷两种方式，对2009年8月至2011年4月来我院妇科门诊就诊的82125例患者进行尿失禁评估，分析尿失禁患病情况及影响因素。结果共发现尿失禁患者15300例（18．63％），同期妇科其他疾病患者66825例（81．37％）。尿失禁的发病比例随着年龄的增加呈上升趋势，且与BMI（OR=1．147，95％CI=0．982-1．342）、顺产次（OR=1．095，95％CI=1．024-1．236）、手术次（OR=1．329，95％CI=1．256-1．730）等相关。54．63％（8358／15300）患者拒绝就诊求助，其中，29．78％（2489／8358）因为经济因素，25．83％（2159／8358）因为心理压力，24．30％（2031／8358）因为不信任医生或治疗效果，20．09％（1679／8358）不了解疾病。结论尿失禁给患者的生活带来许多不便，严重影响患者的身心健康。许多患者不愿就诊，医务人员应做好宣教工作，主动帮助患者提高生存质量。

Objective We investigated urinary incontinence （UI） among patients of the Gynecological Department of Renmin Hospital of Wuhan University, to observe characteristics of women with UI in our province, and to analyze preliminary factors affecting their treatment. Methods We evaluated 15 300 patients treated for UI from August 2009 to April 2011, using site information and questionnaires. We also compared them to 66 825 other gynecology outpatients at our hospital over the same period. Results We found that the incidence of UI tended to increase with age, and was associated with body mass index, parturition, and surgery history. But 54. 63% （8358/15 300） of them refused surgical treatment. Of these 8358 patients, 29.78% （2489/8358） because of economic factors, 25.83% （2159/8358） because of mental stress, and 24. 30% （2031/8358） because of lack of faith in the efficacy of surgical treatment, 20. 09% （1679/8358） did so because of knowing little of the disease. Conclusions UI is inconvenient to patients, and seriously affects their physical and mental health. Many patients refuse surgical treatment. Medical staff should attempt to educate patients better with regard to treatment, and to offer them help to improve the quality of their lives.