炎症性肠病患者大便失禁现状调查及其影响因素分析

Current status and predictors of fecal incontinence in patients with inflammatory bowel disease

目的了解炎症性肠病（roD）患者大便失禁发生的频率和严重程度，探讨患者大便失禁的影响因素。方法采用便利抽样法选取2015年9月-2017年11月在中国医科大学附属第一医院治疗的IBD患者315例，采用一般资料调查表、大便失禁问卷（ICIQ—B）、炎症性肠病调查问卷（IBD—Q）、医院焦虑情绪测定表（naps．A）和医院抑郁情绪测定表（HADS．13）对患者进行调查，采用单因素分析和Logistic回归分析大便失禁发生的影响因素。结果共回收有效问卷300份。72．0％患者报告发生过大便失禁。伴有大便失禁的患者焦虑和抑郁发生率分别为57．4％、45．4％，均高于未发生过大便失禁患者，差异有统计学意义（χ2值分别为5．145、4．354；P〈0．05）。多因素Logistic回归分析结果显示，IBD活动度（OR=1．962）、年龄（OR=6．183）、性别（OR=1．759）、肠道手术史（OR=3．312）、尿失禁（OR=2．029）和肛裂（OR=4．989）是IBD患者大便失禁的独立危险因素（P〈0．05）。结论IBD患者大便失禁影响了患者的生活质量，尤其是患者的情绪，其发生受疾病活动度、年龄、性别、肠道手术史等因素的影响，应得到医护人员的广泛关注。

Objective To investigate the frequency and severity of fecal incontinence （FI） in inflammatory bowel disease （IBD） patients, and to explore the predictors of FI. Methods A total of 315 IBD patients treated in the First Hospital of China Medical University from September 2015 to November 2017 were selected in this study. The participants were investigated using general information questionnaire, International Consultation on Incontinence Questionnaire-Bowel （ICIQ-B）, Inflammatory Bowel Disease Questionnaire（IBD-Q）, Hospital Anxiety and Depression Scale-Anxiety （HADS-A）, and Hospital Anxiety and Depression Scale-Depression （HADS-D）. The univariate analysis and Logistic regression were used to explore the predictors of FI. Results There were 300 questionnaires available. Approximately 72.0% of the patients had experienced F1. The incidence of anxiety and depression in patients with IBD were 57.4% and 45.4%, which were significantly higher compared with patients without IBD （ χ2=5.145, 4.354; P 〈 0.05）. The multivariate Logistic regression showed that IBD activity （OR=1.962）, age （OR=6.183）, gender （OR=1.759）, history of intestinal surgery （OR=3.312）, urinary incontinence （OR=2.029）, and anal fissure （OR=4.989） were independent predictors of FI （P 〈 0.05）. Conclusions Patients with 1BD are suffered from FI that harms their quality of life, especially the emotions. The predictors of FI such as IBD activity, age, gender, and history of intestinal surgery should be fully concerned.