天津市蓟县农村老年人尿失禁与慢性疾病及女性分娩史的关系

目的 了解天津市蓟县农村老年人尿失禁的患病情况和老年人尿失禁与慢性疾病及女性分娩史的关系. 方法 采用整群抽样的方法抽取天津市蓟县所辖的两个乡(镇)卫生院60岁及以上老年人743名,按统一设计的调查问卷,以面对面询问的方式进行入户调查,通过单因素和多因素分析,探讨农村老年人尿失禁与慢性疾病及女性分娩史的关系. 结果 天津市蓟县农村老年人尿失禁患病率为33.4%(248例),女性患病率高于男性(43.2%与22.8%,χ~2=34.70,P<0.0001).多因素Logistic回归分析结果显示,患呼吸系统、前列腺、神经系统、运动系统疾病的老年男性患者尿失禁风险比未患者高,其中患前列腺疾病和神经系统疾病的老年男性患尿失禁风险最高(OR值分别为11.47、11.76).老年女性中,便秘的老年人比无便秘者患尿失禁风险高(OR=1.46),患呼吸系统和运动系统疾病及糖尿病的老年女性患尿失禁风险比未患者高,其中患呼吸系统疾病的老年女性患尿失禁风险最高(OR=4.84);围产期孕次、产次越多患尿失禁风险越高(OR=1.03、1.02);分娩过程中会阴裂伤、伤口感染患尿失禁风险高(OR=1.72、1.65). 结论 天津市蓟县农村老年人尿失禁患病率较高,老年人尿失禁的发生与多种慢性疾病有关,同时女性分娩史也影响老年人尿失禁的发生.

Relationship of chronic diseases and the history of gestation and delivery with urinary incontinence among elderly people of rural areas in Jixian county, Tianjin

Objective To explore the relationship of chronic diseases and the history of gestation and delivery with urinary incontinence (UI) among elderly people of rural areas, so as to lay a scientific foundation for formulating strategies of prevention and treatment for UI. Methods A cross-sectional study was carried out in two towns of Jixian county, Tianjin. A total of 743 people aged 60 years and over were selected with cluster sampling, and all information were collected with a standardized structured questionnaire by face-to-face interview. The relationships of chronic diseases and the history of gestation and delivery with UI were analyzed with univariate analysis and multivariate Logistic regression method. Results Prevalence of UI was 33. 4% among the people aged 60 years and over in two towns of Jixian, and it was higher in females than in males (43. 2% vs. 22.8%, χ~2= 34.70, P<0.0001). Logistic regression analysis revealed that the chronic respiratory diseases, prostate disease, neurological diseases or motor system diseases were all associated with UI in men, and the elderly men who suffered from prostate disease and neurological diseases had the highest risk of UI (OR=11. 47, OR=11. 76). Constipation, chronic respiratory diseases, diabetes mellitus and motor system diseases were all associated with UI in women, and the elderly women with chronic respiratory diseases had the highest risk of UI (OR = 4. 84). Elderly women who had more gravidity (OR = 1. 03), more parity (OR= 1.02), perineal laceration (OR = 1.72) and wound infection (OR= 1. 65) during delivery had higher prevalence of UI. Conclusions Prevalence of UI is higher among the elderly people in rural areas of Jixian county, and several chronic diseases and gestation and delivery history in women are all associated with UI in the elderly. For the prevention of UI, the elderly should actively look for treating their chronic diseases and the medical workers should strengthen health education or health care for pregnant women.