成都市脑卒中急性期大小便失禁相关因素研究

目的研究脑卒中后大小便失禁发生相关因素,以进行针对性治疗及有效性护理。方法采用定点连续抽样方法,对成都市3家医院2010年8月-2012年10月入院的257例脑卒中患者进行调查,完成脑卒中临床特征表格的填写。所得数据采用SPSS 19.0分别进行单因素χ2检验、t检验分析及多因素二分类logistic回归分析。结果脑卒中患者大小便失禁发生率为16.7%。单因素分析显示脑卒中发生大小便失禁的相关因素为年龄、发病时意识障碍、发病2 h后不能坐起站立、伴肺部感染、伴心功能不全以及本次发病是否伴并发症。多元回归分析显示：发病时是否伴意识障碍[OR=4.186,95%CI（2.010,8.715）,P〈0.001]、是否伴肺部感染[OR=3.490,95%CI（1.616,7.539）,P=0.001]、年龄[OR=1.036,95%CI（1.004,1.069）,P=0.029]是大小便失禁的危险因素,发病时伴意识障碍、肺部感染的患者更容易发生大小便失禁,年纪越大越容易发生大小便失禁。结论卒中后患者易发生大小便失禁,伴意识障碍、肺部感染以及年龄增大是大小便失禁发生的独立因素。

Related Factors for Urinary and Fecal Incontinence in Post-stroke Patients in Chengdu Area

Objective To study related factors for urinary and fecal incontinence in post-stroke patients, in order to present targeted treatment and effective care. Methods With continuous sampling methods, we prospectively evaluated 257 stroke patients admitted to our hospital from August 2010 to October 2012, and had the clinical features form completely filled. All statistical analysis was performed using SPSS 19.0. Results Urinary and fecal incontinence rate was 16.7%. Univariate analysis showed that the related factors for the incidence of urinary and fecal incontinence in post-stroke patients included the onset of disturbance of consciousness, disability to sit up or stand two hours after the onset, being complicated with pulmonary infection or ventricular dysfunction, complications, and constipation. A multivariate analysis identified three factors to be independently associated with urinary and fecal incontinence in post-stroke patients, including disturbance of consciousness [OR=4.186, 95%CI（2.010, 8.715）, P 〈 0.001], being complicated with pulmonary infection [OR=3.490, 95%CI（1.616, 7.539）, P=0.001] and age [OR=1.036, 95%CI（1.004, 1.069）, P=0.029]. Conclusion Post-stroke patients are most likely to develop urinary and fecal incontinence, and disturbance of consciousness, being complicated with pulmonary infection and age are three independent factors.