脑卒中后尿失禁发生率、预后及其危险因素的前瞻性研究  

Prevalence,risk factors and outcomes of urinary incontinence in patients with stroke

作　　者：苏雅茹[1] 王坚[1] 蒋雨平[1] 

机构地区：[1]复旦大学附属华山医院神经内科,上海200040

出　　处：《中风与神经疾病杂志》2004年第6期518-520,共3页Journal of Apoplexy and Nervous Diseases

基　　金：上海市科委自然基金资助(014119019)

摘　　要：目的前瞻性研究脑卒中后尿失禁发生率、预后及其危险因素。方法急性脑卒中住院患者158名,对患者发病1周和随访3个月的排尿情况及高危因素进行分析。结果发病1周尿失禁患者占42.4%,排尿困难占7.6%,50.0%排尿正常。单因素分析表明高龄、血肿大、伴失语、额叶和丘脑病变、及病情严重的患者易发生尿失禁。Logistic多元回归分析表明失语(OR值9.324,95%可信区间1.94～44.79);额叶病变(OR值24.6,95%可信区间2.78～216);基底节病变(OR值6.76,95%可信区间1.0～42)是尿失禁发生的危险因素。3个月存活患者中尿失禁占25.6%,高龄、入院时病情严重,额叶病变患者尿失禁不易恢复。结论高龄、失语、额叶病变、发病1周病情严重程度是影响卒中后尿失禁发生及预后的危险因素。Objective To prospectively investigate the prevalence,risk factors and outcomes of urinary incontinence (UI) in patients with stroke.Methods 158 acute stroke admissions were involved between July 1,2002,and March 1,2003.Patients were classified by continence status at the 1st week:group UI,group UC (urinary continent) and group DV (difficulty of voiding).Age,sex,diabetes,hypertension,atrial fibrillation,CSS,MBI and FIM were recorded.Outcome data about continence status were collected at 3 months.Results At 1st week,the proportions of patients with UI,UC,and DV were 42.4%,50% and 7.6%,respectively (25.6%,74.4%,and 0% at 3-month follow-up).In univariate analysis,age,aphasia,larger volume of clot,lesions of frontal lobe,basal ganglia and thalamus,greater disability(evaluated according the CSS,MBI and FIM scores) were risk factors to the occurrence of UI.Logistic multivariate analyses showed that aphasia (OR 9.324,95% CI 1.94 to 44.79),frontal lobe lesions(OR 24.6,95%CI 2.78 to 216),basal ganglia (OR 6.76,95%CI 1.0 to 42) were all significantly associated with incontinence.At 3-month follow-up,those who retain incontinence were older and greater disability than those who recover continence (P<0.05).Conclusion Incontinence is a common sequela of stroke.Initial incontinence and recovery at 3-month were associated with age, aphasia,lesions of frontal lobe and greater disability.

关 键 词：脑卒中 尿失禁 危险因素 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]