直肠癌术后老年患者尿失禁现状调查及影响因素分析

目的了解住院老年直肠癌患者术后尿失禁发生现状及影响因素,为制订老年直肠癌患者术后护理方案提供科学依据。方法选取2017年5月-2018年5月收治于上海交通大学附属第六人民医院徐汇分院的直肠癌围手术期老年患者,采用自制一般资料问卷及国际尿失禁咨询委员会尿失禁问卷表简表(ICIQ-SF)进行调查。共发放问卷170份,回收有效问卷159份,有效回收率93.5%。结果 159例直肠癌术后老年患者中,发生尿失禁者38例(23.9%)。单因素分析显示,患者的年龄、糖尿病史、腹部及盆腔手术史、体质量指数(BMI)、手术时间、术后尿路感染发生情况均影响老年直肠癌患者术后尿失禁的发生(P<0.05)。Logistic回归分析显示,年龄较大、围术期发生尿路感染、BMI>25、有腹部及盆腔手术史是老年直肠癌患者术后尿失禁的主要影响因素。结论直肠癌术后老年患者尿失禁发生情况不容乐观。护士术前需评估患者相关情况,特别是年龄、有无腹部或盆腔手术史、体质量指数、是否存在围术期尿路感染等,并针对相关原因尽早进行护理干预。

Investigation of Urinary Incontinence in Elderly Patients after Rectal Cancer Surgery and Analysis of Its Influencing Factors

Objective To investigate the status quo of postoperative urinary incontinence in elderly patients with rectal cancer and analyze the relevant influencing factors, so as to provide scientific basis for formulating postoperative nursing program for elderly patients with rectal cancer. Methods The elderly patients with rectal cancer admitted to the Sixth People’s Hospital Affiliated with Shanghai Jiao Tong University(Xuhui Branch) from May 2017 to May 2018 were selected and surveyed with self-made General Information Questionnaire and Short Form of International Consultation on Incontinence questionnaire(ICIQ-SF). A total of170 questionnaires were distributed and 159 valid questionnaires were recovered, with an effective recovery rate of 93.5%. Results Among 159 elderly patients with rectal cancer, 38(23.9%) had urinary incontinence after receiving rectal cancer surgery. Univariate analysis showed that patient’s age, history of diabetes, history of abdominal and pelvic surgery, body mass index(BMI), time of operation, and postoperative urinary tract infection all affected the occurrence of postoperative urinary incontinence in elderly patients with rectal cancer(P<0.05). Logistic regression analysis showed that older age, perioperative urinary tract infection, BMI>25,and history of abdominal and pelvic surgery were the main influencing factors of postoperative urinary incontinence in elderly patients with rectal cancer. Conclusion The incidence of urinary incontinence in elderly patients after rectal cancer surgery is not neglectful. Before surgery, nurses need to assess relevant conditions of patients, especially age, history of abdominal or pelvic surgery, body mass index, occurrence of perioperative urinary tract infection and other factors,and carry out targeted nursing intervention as soon as possible.