本文選題：糞失禁 + 危險(xiǎn)因素��； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：研究背景 糞失禁(fecal incontinence, FI)是女性盆底功能障礙性疾病的重要組成部分,并不罕見,并且常常與尿失禁(urinary incontinence, UI)、盆腔器官脫垂(pelvic organ prolapse, POP)等其他盆底功能障礙性疾病(pelvic floor dysfunction diseases, PFD)同時(shí)發(fā)生。其定義尚有爭(zhēng)議,多數(shù)研究將其定義為曾出現(xiàn)過經(jīng)肛門不自主地漏出固體便、液體便或氣體的現(xiàn)象。據(jù)臨床表現(xiàn)可將糞失禁分為被動(dòng)型、急迫型和漏糞。糞便性狀、腸動(dòng)力、神經(jīng)功能、肛門括約肌等盆底肌肉功能異常等均可導(dǎo)致糞失禁。 糞失禁的患病率在各文獻(xiàn)的報(bào)道中差異較大,主要與調(diào)查人群、判定標(biāo)準(zhǔn)、診斷方法等不同有關(guān)。老年人中糞失禁的患病率較高,可能與其盆底功能障礙、腸動(dòng)力和認(rèn)知能力下降等有關(guān)。因很多患者羞于就診,導(dǎo)致了糞失禁的實(shí)際患病率被低估。 糞失禁可產(chǎn)生諸多影響,不僅造成患者巨大的身心痛苦、生活不便、甚至人格改變,而且還給家庭和社會(huì)帶來沉重負(fù)擔(dān),嚴(yán)重影響患者的生活質(zhì)量。 目的 本研究調(diào)查了北京市養(yǎng)老院65歲及以上的老年女性,旨在研究老年女性糞失禁的患病率及相關(guān)危險(xiǎn)因素,同時(shí)評(píng)估糞失禁對(duì)老年女性生活質(zhì)量的影響。 方法 1.走訪北京市多家養(yǎng)老院,以65歲及以上的神志清楚、精神正常的老年女性為研究對(duì)象。糞失禁患者納入標(biāo)準(zhǔn)：出現(xiàn)過固體便、液體便或氣體從肛門不自主漏出的現(xiàn)象；排除標(biāo)準(zhǔn)：神經(jīng)系統(tǒng)疾病或損傷所致糞失禁,有認(rèn)知功能障礙者,有精神障礙者,老年癡呆者。研究對(duì)象均自填問卷。 2.問卷內(nèi)容：調(diào)查對(duì)象的人口學(xué)資料、疾病相關(guān)因素、糞失禁嚴(yán)重程度及糞失禁生活質(zhì)量評(píng)分(FIQL)。 3.應(yīng)用SPSS16.0軟件進(jìn)行二元非條件logistic統(tǒng)計(jì)分析,采用單因素Logistic回歸分析篩選危險(xiǎn)因素,將單因素分析中P0.05的變量及文獻(xiàn)中曾報(bào)道的危險(xiǎn)因素代入,行多因素非條件logistic回歸分析。 結(jié)果 共計(jì)回收有效問卷372份,其中失禁患者24例。研究對(duì)象平均年齡(74±5)歲,糞失禁患者平均病程(4.5±4.2)年。糞失禁總的患病率約為6.5%,并隨年齡增長(zhǎng)而顯著增加。有70.8%(17/24)的糞失禁患者同時(shí)合并其他盆底功能障礙性疾病(包括尿失禁、盆腔臟器脫垂)。多因素分析發(fā)現(xiàn),產(chǎn)科相關(guān)肛門括約肌損傷(OR=6.670)、合并其他盆底功能障礙性疾病(OR=5.749)、第一胎體重(OR=5.519)和生產(chǎn)(順產(chǎn))次數(shù)(OR=3.722)4個(gè)因素為發(fā)生糞失禁的獨(dú)立危險(xiǎn)因素。此外,由于糞失禁,患者的生活質(zhì)量明顯下降。 結(jié)論 隨著我國人口老齡化,糞失禁等盆底功能障礙性疾病的發(fā)病率呈逐漸上升趨勢(shì)。糞失禁雖不會(huì)威脅到患者的生命,但是嚴(yán)重影響其生活質(zhì)量。研究其發(fā)病危險(xiǎn)因素,可為糞失禁的預(yù)防、癥狀的改善提供重要依據(jù)。
[Abstract]:Research background Fecal incontinence (FII) is an important component of female pelvic floor dysfunction, and is often associated with urinary incontinence, urinary incontinence, pelvic organ prolapse organ prolapse, and other pelvic floor floor dysfunction diseases (PFDs). The definition is still controversial. Most studies have defined it as the phenomenon of involuntary leakage of solid, liquid or gas through the anus. According to clinical manifestation, fecal incontinence can be divided into passive type, urgent type and leakage type. Fecal traits, intestinal motility, nerve function, and pelvic floor muscle dysfunction, such as anal sphincter, can lead to fecal incontinence. The prevalence rate of fecal incontinence varies greatly in the reports of the literature, which is mainly related to the different populations, criteria and diagnostic methods. The higher prevalence of fecal incontinence in the elderly may be related to pelvic floor dysfunction, intestinal motility and cognitive impairment. The actual prevalence of fecal incontinence is underestimated because many patients are shy about seeing a doctor. Fecal incontinence can have many effects, which not only cause great physical and mental pain, inconvenience of life, even personality change, but also bring heavy burden to family and society, and seriously affect the quality of life of patients. Purpose The purpose of this study was to investigate the prevalence and risk factors of fecal incontinence in elderly women aged 65 and above in Beijing nursing home and to evaluate the influence of fecal incontinence on the quality of life of elderly women. Method 1. To visit several nursing homes in Beijing, elderly women aged 65 and above who are mentally conscious and mentally normal are the subjects of the study. Fecal incontinence patients included in the standard: solid stool, fluid or gas from the anal involuntary leakage phenomenon; exclusion criteria: nervous system diseases or injuries caused by fecal incontinence, cognitive impairment, mental disorders, Alzheimer's disease. The subjects were all self-filled out questionnaires. 2. Contents of the questionnaire: demographic data, disease related factors, severity of fecal incontinence and quality of life score of incontinence. 3. The binary unconditioned logistic statistical analysis was carried out by using SPSS16.0 software, and the risk factors were screened by univariate Logistic regression analysis. The variables of P0.05 in univariate analysis and the risk factors reported in the literature were added to the statistical analysis, and the multivariate unconditioned logistic regression analysis was carried out. Result A total of 372 valid questionnaires were collected, including 24 incontinence patients. The average age of the subjects was 74 鹵5 years, and the mean course of disease was 4.5 鹵4.2 years in patients with fecal incontinence. The total prevalence of fecal incontinence was about 6.5 and increased significantly with age. 70.8% of patients with fecal incontinence also have other pelvic floor disorders (including urinary incontinence, pelvic organ prolapse). Multivariate analysis showed that four factors, OR6.670, OR5.749, OR5.519 and OR3.722) were independent risk factors of fecal incontinence. In addition, due to fecal incontinence, the quality of life of patients significantly decreased. Conclusion With the aging of population in China, the incidence of pelvic floor disorders such as fecal incontinence is on the rise. Fecal incontinence does not threaten patients' lives, but seriously affects their quality of life. The study of its risk factors can provide an important basis for the prevention of fecal incontinence and the improvement of symptoms.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 朱蘭;王巍;;產(chǎn)科會(huì)陰撕裂新分類及國際最新縫合修補(bǔ)術(shù)[J];中國實(shí)用婦科與產(chǎn)科雜志;2010年04期

，

本文編號(hào)：1780638