急性大脑半球梗死后尿失禁临床分析

目的探讨急性大脑半球梗死后患者尿失禁与失语、病灶部位、认知功能及日常生活能力关系。方法１５４例急性大脑半球梗死患者在入院后４８小时内测定简易精神状态（ＭＭＳ）和日常生活活动能力（ＡＤＬ），１个月后复查。５３例尿失禁者做Ｂ超检查。结果３４４％的患者伴尿失禁，左半球病变的尿失禁率（４３２％）高于右半球病变（２２６％）（Ｐ＜００１）。同侧皮层＋皮层下梗死的尿失禁率为６５７％。尿失禁者失语率（７３６％）高于无尿失禁者（Ｐ＜０００１）。入院时和１个月后尿失禁者ＭＭＳ和ＡＤＬ都比无尿失禁者低（Ｐ＜０００１）。结论脑梗死伴失语时常不能正确表达排尿而引起尿失禁。认知障碍和日常生活能力下降是尿失禁的重要因素，随ＭＭＳ和ＡＤＬ值升高，尿失禁也消失。

Clinical analysis of urinary incontinence after acute cerebrum hemispheric infarction

Objectives\ To detect the relationship between urinary incontinence and aphasia,region of focus,cognitive function and activity of daily living (ADL) after acute cerebrum hemispheric infarction(ACHI).Methods\ The minimental state (MMS) and ADL of 154 cases of the patients with ACHI were evaluated within 48 hours after hospitalization and repeated one month later.53 cases with urinary incontinence were examined with B-type ultrasound.Results\ 34.4% of the patients with ACHI had urinary incontinence.The incidence rate of urinary incontinence with ACHI in the left side(43.2%) was higher than that in the right side (22.6%)( P <0.001) significantly.The incidence rate of urinary incontinence with homopleural cortical and subcortical infarction was 65.7%.The incidence rate of aphasia(73.6%) of the patients with urinary incontinence was higher than that of the patients with continence significantly( P <0.001) both in 48 hours after hospitalization and one month later.Conlusions\ Aphasia after ACHI can cause urinary incontinence because the patiants usually cannot express urination exactly.Cognitive disorder and ADL impairment are important factors of urinary incontinence.Urinary incontinence will disappear gradually while MMS and ADL is improved.