本文選題：尿失禁 + 女性��； 參考：《泰山醫(yī)學院》2014年碩士論文

【摘要】：目的本次流行病學調(diào)查通過對萊蕪當?shù)氐貐^(qū)已婚婦女的問卷調(diào)查發(fā)現(xiàn)我市農(nóng)村已婚婦女尿失禁的患病情況,并探討分析其發(fā)病的影響因素,為制定適合本地區(qū)的尿失禁干預防范措施而提供理論依據(jù)。1.調(diào)查萊蕪市已婚婦女UI不同類型的患病率。2.調(diào)查萊蕪市已婚婦女UI不同類型的構成比特點。3.分析SUI發(fā)病的危險因素。4.根據(jù)調(diào)查研究的結果制定適合本地區(qū)的防治措施,以有效的降低本地區(qū)UI的發(fā)病率。5.為已婚婦女尿失禁提供流行病學資料。方法選擇2012年10月至2013年6月我市萊城區(qū)13鎮(zhèn)70村的18—90周歲的當?shù)匾鸦檗r(nóng)村婦女為調(diào)查對象。調(diào)查所用的調(diào)查表主要根據(jù)布里斯托女性下尿路癥狀調(diào)查問卷(BFLUTS)改編,包括一般資料問卷、月經(jīng)及胎產(chǎn)史、既往疾病史以及個人史、漏尿情況、體格檢查、婦科檢查以及輔助檢查。在進行預調(diào)查、人員培訓后正式調(diào)查。所有數(shù)據(jù)資料如實錄入Epidata3.0建立數(shù)據(jù)庫,一人錄入,一人核對。所有統(tǒng)計分析采用SPSS13.統(tǒng)計包處理。一般計量資料采用均數(shù)±標準差表示,計數(shù)資料采用χ2檢驗,單因素分析和多因素分析采用Logistics回歸分析,以確定優(yōu)勢比(OR)和95%可信區(qū)間(CI)。結果1.在調(diào)查人群中,共有1142人患有不同類型的尿失禁,占43.92%。其中壓力性尿失禁571人,占21.96%(571/2600),急迫性尿失禁199人,占7.65%(199/2600),混合性尿失禁372人,占14.31%(372/2600)。在疾病構成比中,壓力性尿失禁的發(fā)病人數(shù)占尿失禁總人數(shù)的50.00%,急迫性尿失禁的發(fā)病人數(shù)占尿失禁總人數(shù)的17.43%,混合性尿失禁的發(fā)病人數(shù)占尿失禁總人數(shù)的32.57%。2.①尿失禁的發(fā)病率隨年齡的上升而上升,50歲~組和60歲~組略高于70歲~組8 0歲~組,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。②在各年齡組中,~29歲組、30歲~組、40歲~組和50歲~組不同類型尿失禁的構成比由高到低基本是SUIUUIMUI,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。但到了60歲之后的組別,不同類型尿失禁的構成比由高到低基本是MUISUIUUI,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。在60歲之前,SUI是尿失禁的主要類型,其構成比在尿失禁中占絕對優(yōu)勢,經(jīng)統(tǒng)計學檢驗有極顯著性差異(P0.01),且這一優(yōu)勢與年齡增長無明顯關系,經(jīng)統(tǒng)計學檢驗無顯著性差異(P0.05)。但在60歲之后,MUI和UUI的構成比大步上升,尤其是MUI上升明顯,且隨年齡增長構成比也增加,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。3.企事業(yè)單位和農(nóng)民是各種職業(yè)中尿失禁發(fā)病率最高的人群(分別為57.69%、51.46%),經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05),可能與企事業(yè)單位人員缺乏鍛煉而農(nóng)民勞動強度偏大有關。不同職業(yè)的不同類型尿失禁的構成比由高到低基本是SUIUUIMUI,且SUI的發(fā)病率明顯高于UUI、MUI,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。農(nóng)民的壓力性尿失禁構成比最重(61.79%),企事業(yè)單位人員的混合性尿失禁構成比最重(51.67%),經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。4.不同文化程度的尿失禁患病率無明顯不同,經(jīng)統(tǒng)計學檢驗無顯著性差異(P0.05)。不同文化程度的不同類型UI構成比無明顯不同,經(jīng)統(tǒng)計學檢驗無顯著性差異(P0.05)。5.①尿失禁的發(fā)病率隨分娩次數(shù)的增加而明顯增加,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。②分娩3次及以上后,尿失禁的發(fā)病率顯著增加,經(jīng)統(tǒng)計學檢驗有極顯著性差異(P0.01)。③SUI、UUI的發(fā)病率隨分娩次數(shù)的增加而增加,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。但MUI的發(fā)病率無明顯隨分娩次數(shù)的增加而增加的趨勢,經(jīng)統(tǒng)計學檢驗無顯著性差異(P0.05)。SUI的構成比有明顯隨年齡增加的趨勢,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。SUI的構成比無明顯隨年齡增加的趨勢,經(jīng)統(tǒng)計學檢驗無顯著性差異(P0.05)。MUI的構成比有明顯隨年齡下降的趨勢,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。6.①隨著胎兒體重的增加,尿失禁的發(fā)病率有增加的趨勢,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。②隨著胎兒體重的增加,SUI、UUI、MUI都有增加的趨勢,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。③胎兒體重≥4kg后,患各種類型尿失禁的比例均明顯增加,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。④各種類型的尿失禁構成比均有隨胎兒體重增加而增加的趨勢,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。;⑤SUI的構成比在同胎兒體重組別中最大,經(jīng)統(tǒng)計學檢驗有顯著性差異(P0.05)。7.壓力性尿失禁可能的危險因素分別是:年齡、職業(yè)、分娩次數(shù)、絕經(jīng)、便秘、慢性咳嗽史、盆腔手術史、腰圍、體重指數(shù)。經(jīng)多因素Logistic回歸分析得出分娩3次及以上、絕經(jīng)、便秘、盆腔手術史、體重指數(shù)≥28.0等5個因素是壓力性尿失禁的危險因素。8.急迫性尿失禁可能的危險因素分別是:分娩次數(shù)、絕經(jīng)、便秘、體重指數(shù)、糖尿病、WHR。經(jīng)多因素Logistic回歸分析得出最終分娩3次及以上、便秘、體重指數(shù)≥28.0等3個因素是急迫性尿失禁的危險因素。9.混合性尿失禁可能的危險因素分別是:年齡、職業(yè)、分娩次數(shù)、絕經(jīng)、便秘、慢性咳嗽史、盆腔手術史、腰圍、體重指數(shù)。經(jīng)多因素Logistic回歸分析得出最終年齡≥50歲、便秘、絕經(jīng)等3個因素是急迫性尿失禁的危險因素。結論1.尿失禁發(fā)病的主要類型為壓力性尿失禁,其危險因素主要為分娩3次及以上、絕經(jīng)、便秘、盆腔手術史、體重指數(shù)≥28.0。其次為混合性尿失禁和急迫性尿失禁,其危險因素分別為年齡≥50歲、便秘、絕經(jīng);分娩3次及以上、便秘、體重指數(shù)≥28.0。2.通過各種干預措施,制定適合本地區(qū)的防治措施,爭取降低本地區(qū)尿失禁的發(fā)病率。
[Abstract]:Objective to find out the prevalence of urinary incontinence of married women in the rural areas of Laiwu, and to analyze the influencing factors of the incidence of urinary incontinence in the rural areas of our city, and to provide a theoretical basis for the investigation of different types of UI married women in Laiwu. The prevalence rate of.2. in Laiwu married women UI different types of constituent ratio.3. analysis of the risk factors of SUI disease.4. based on the results of the study to formulate appropriate local control measures to effectively reduce the incidence of UI in the local region.5. for married women to provide flow disease information for urinary incontinence. Methods selected from October 2012 to 2013 In June, 70 villages of 13 towns in 13 towns of Laicheng district were investigated. The questionnaire was mainly based on the Bristow female lower urinary tract symptom questionnaire (BFLUTS), including the general data questionnaire, menstruation and fetal history, history of past diseases and personal history, leakage of urine, physical examination, gynecologic examination. All data were recorded in Epidata3.0 to establish database, one person was recorded and one person checked. All statistical analysis was processed by SPSS13. statistical package. The general measurement data were expressed with mean standard deviation, and the count data were analyzed by x 2 test, single factor analysis and multi cause. Logistics regression analysis was used to determine the dominance ratio (OR) and 95% confidence interval (CI). Results 1. of the respondents, 1142 were suffering from different types of urinary incontinence, 571 of which were stress urinary incontinence, 21.96% (571/2600), 199 of urgent incontinence, 7.65% (199/2600), and 372 of mixed urinary incontinence, 14.31% (372/26). 00). In the ratio of disease composition, the number of stress urinary incontinence accounts for 50% of the total incontinence, 17.43% of the total number of incontinence in urinic incontinence, the incidence of 32.57%.2. in the total number of incontinence in urinary incontinence, the incidence of urinary incontinence increased with the increase of age, and the 50 years and 60 years of age are slightly higher. There were significant differences between 70 years old and 80 years old (P0.05). (2) in all age groups, ~29 years, 30 years old, 40 years old and 50 years old, the constituent ratio of different types of urinary incontinence was basically SUIUUIMUI, and statistically significant difference (P0.05). But after 60 years of age, the composition of different types of urinary incontinence There was a significant difference in MUISUIUUI from high to low (P0.05). Before the age of 60, SUI was the main type of urinary incontinence, its constituent ratio was dominant in urinary incontinence, and statistically significant difference (P0.01), and there was no significant relationship between this advantage and annual growth, and there was no significant difference in statistical test (P0 .05). But after the age of 60, the composition of MUI and UUI is higher than the big step, especially the increase of MUI, and the ratio of the age increases. There is a significant difference (P0.05).3. enterprises and farmers are the highest incidence of urinary incontinence (57.69%, 51.46%) in various professions (respectively, 51.46%), and the statistical test has a significant difference. The difference (P0.05) may be related to the lack of exercise for the personnel of enterprises and institutions. The composition of different types of urinary incontinence in different professions is basically SUIUUIMUI, and the incidence of SUI is significantly higher than that of UUI, MUI, statistically significant difference (P0.05). The proportion of stress urinary incontinence in farmers is the heaviest (61.79%), The proportion of mixed urinary incontinence in enterprises and institutions was the heaviest (51.67%). There was significant difference (P0.05) in statistical test. There was no significant difference in the prevalence rate of urinary incontinence between.4. and different cultural degrees. There was no significant difference (P0.05). The composition of different types of UI in different cultural degrees was not significantly different, and there was no significant statistical test. The incidence of urinary incontinence (P0.05).5. (1) increased significantly with the increase of the number of childbirth, and there was a significant difference (P0.05). After 3 times of childbirth and above, the incidence of urinary incontinence increased significantly, and statistically significant difference (P0.01). (3) the incidence of SUI, UUI increased with the number of childbirth, and was statistically analyzed. There was a significant difference (P0.05). However, the incidence of MUI was not significantly increased with the increase of the number of births. There was no significant difference in statistical test (P0.05), the constituent ratio of.SUI was obviously increased with age, and there was a significant difference (P0.05) the constituent ratio of.SUI was not obviously increased with age. There was a significant difference in the composition ratio of.MUI (P0.05), and the statistical test showed significant difference (P0.05).6. (1) the incidence of urinary incontinence increased with the increase of fetal weight, and statistically significant difference (P0.05). (2) with the increase of fetal weight, SUI, UUI, MUI all increased. There was a significant difference in statistical test (P0.05). (3) the proportion of various types of urinary incontinence increased obviously after the fetal weight was more than 4kg, and there was a significant difference (P0.05). (4) there was a tendency to increase with the increase of fetal weight in all types of urinary incontinence (P0.05 The constituent ratio of SUI was the largest in the group of the same fetal weight. The possible risk factors for.7. stress urinary incontinence (P0.05) were age, occupation, number of childbirth, menopause, constipation, chronic cough, pelvic surgery, waist circumference, body mass index, and 3 times of birth and with multiple factors Logistic regression analysis. 5 factors such as the history of menopause, constipation, pelvic surgery, body mass index, or more than 28 were risk factors for stress incontinence of urinary incontinence. The possible risk factors for.8. urgent incontinence were the number of childbirth, menopause, constipation, body mass index, diabetes, and WHR. by multiple factors Logistic regression analysis, 3 and more final deliveries, constipation, body mass index more than 28 The risk factors for acute urinary incontinence were 3 factors: age, occupation, times of delivery, menopause, constipation, chronic cough, pelvic surgery, waist circumference, body mass index. The final age of 50 years, and 3 factors such as constipation, menopause, and 3 factors were acute urinary incontinence. Conclusion 1. the main types of urinary incontinence are stress urinary incontinence. The main risk factors are 3 times of delivery and above, menopause, constipation, pelvic surgery, body mass index (BMI) more than 28.0., followed by mixed urinary incontinence and urgent incontinence. The risk factors are age 50 years, constipation, menopause, and childbirth 3 times and above, respectively. The body mass index (28.0.2.) is more than 10%. Through various intervention measures, appropriate measures for prevention and control in this area are worked out to reduce the incidence of urinary incontinence in this area.
【學位授予單位】：泰山醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R711.59

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