北京市养老院中女性尿失禁的患病现况和危险因素研究

Investigation on prevalence and risk factors of urinary incontinence among aged women at nursing home in Beijing

目的了解北京市养老院中女性尿失禁的患病现况和危险因素，为制订相应的卫生策略提供参考。方法采用随机抽样的方法，在北京市选择6个区作为调查点，由经过培训的调查员应用统一设计的调查表对养老院中符合条件的老年女性进行询问式问卷调查。数据分析应用SPSS16．0软件完成，危险因素的分析采用非条件Logistic回归分析。结果642例老年女性完成本次调查，尿失禁患病率为38．0％（244／642）。尿失禁患者对自身病情知晓率为38．5％（94／244），就诊率为7．8％（19／244），治疗率为6．6％（16／244）。单因素分析结果显示，从事体力劳动和患呼吸、消化、泌尿、心脑血管、神经、妇科疾病及既往月经状况不佳、结婚年龄〈21岁、怀孕≥4次、经历过自然分娩和剖宫产、便秘、排便失禁、活动能力受限、饮酒史等是发生尿失禁的危险因素。经多因素非条件Logistic回归分析，8个因素进入回归方程，为尿失禁独立的危险因素，分别为结婚年龄小于21岁（OR=1．5，95％CI：1．0～2．3，P〈0．05），怀孕≥4次（OR=1．7，95％CI：1．1～2．4，P〈0．05），既往月经状况不佳（OR=1．7，95％CI：1．0～2．7，P〈0．05），患呼吸系统疾病（OR=1．6，95％CI：1．0～2．6，P〈0．05）、泌尿系统疾病（OR一2．4，95％CI：1．4～4．1，P〈0．01）、心脑血管疾病（OR=2．0，95％，：1．3～3．0，P〈0．01）、妇科疾病（OR=3．4，95％CI：2．0～5．6，P〈0．01）及活动能力受限（OR=2．5，95％CI：1．5～4．0，P〈0．01）。结论尿失禁在养老院女性中患病率较高，应针对危险因素进行干预和相应的治疗。

Objective To evaluate prevalence and risk factors of urinary incontinence （UI） among aged women living at nursing homes in Beijing, and provide references of relative health strategy. Methods Totally 642 women aged 60 years and over were randomly selected at nursing homes from 6 districts in Beijing. A questionnaire survey was conducted using International Consultationon Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module （ICIQ- FLUTS） recommended by International Consultation on Incontinence （ICI）. Results The prevalence rate of UI was 38.0% （244/642） among whom 38.5% （94/244） of participants knew their health conditions, 7.8% （19/244） visited hospital and 6.6% （16/244） received medical or operational treatment. The proportions of respiratory disease （27.0% vs. 14.6%）, digestive disease （23.4% vs. 15.3%）, urological disease（24.6%vs. 8.5%）, cardio-cerebralvascular disease（74.2%vs. 53.5%）, neurological disease （ 9.4% vs. 5.0%）, obstetric disease （ 27.5% vs. 10.1%）, menstrual disorder （21.4%vs. 14.4%）, getting married before aged 21 years （51.5%vs. 40.8%）, being pregnant more than 4 times（50.2%vs. 40.9%）, the experience of both cesarean and natural birth （4. 0%vs. 0. 8%）, constipation （40.2 % vs. 29.4% ）, fecal incontinence （13.1% vs. 4.0 % ）, uneasy movement （22.5 vs. 10. 6%） and drinking （8.6%vs. 3.5%） were higher in women with UI than in women without UI （P〈0.05 or P〈0.01）. Eight risk factors that were entered into logistic regression model included getting married before 21 years old （OR=I. 5, 95 % CI： 1.0-2.3,P〈0.05）,being pregnant more than 4 times（OR= 1.7, 95 %CI： 1.1-2.4,P〈0.05） ,menstrual disorder（OR= 1.7, 95%CI： 1.0-2.7, P（ 0.05）, respiratory disease（OR=l. 6, 95~CI： 1.0-2.6,P^0.05） ,urological disease（OR=2.4, 95% CI： 1.4-4.1, P〈0.01）, cardio cerebraivaseular disease（OR=2.0, 95%CI： 1.3-3.0, P〈0.01）, obstetric disease（OR-- 3.4, 95 %CI： 2.0 5.6, P〈0.01）, moving uneasily（OR = 2.5, 95% CI： 1.5- 4.0, P〈0.01）. Conclusions UI is a common disease among women residing at nursing homes. Specific measures including intervention and clinical treatment targeting risk factors should be conducted.