不同性别的肛门失禁患者生活质量差异  

Quality of life differences in fecal incontinence patients of different gender

作　　者：龚国杰[1] 牛伟亚[1] 孟塬[1] 艾尼瓦尔.巴高 王俊[1] 许婧 GONG Guojie;NIU Weiya △;MENG Yuan;Ainval·Bajo;WANG Jun;XU Jing(Department of General Surgery,North Hospital of Xinjiang Uygur Autonomous RegionPeople′s Hospital,Urumqi,Xinjiang 830054,Chin)

机构地区：[1]新疆维吾尔自治区人民医院北院普外科,乌鲁木齐830054

出　　处：《检验医学与临床》2018年第9期1259-1262,1265,共5页Laboratory Medicine and Clinic

摘　　要：目的比较不同性别的肛门失禁患者生活质量的差异。方法回顾性分析该院2013年1月至2016年1月收治的61例肛门失禁患者。所有患者均行肛门直肠测压和直肠腔内超声检查,通过Wexner和Vaizey评分量表评估临床症状严重程度,运用肛门失禁生活质量评分系统(FIQL)或欧洲五维健康量表(EQ-5D)评估患者生活质量。结果不同性别患者中有过盆腔放疗或低位直肠切除术的例数差异有统计学意义(P<0.05)。61例患者中,94.3%的女性和50.0%的男性有外括约肌功能受损,42.3%的男性和71.4%的女性有内括约肌功能受损,男性与女性差异有统计学意义(P<0.05),男性的直肠敏感性下降多见。Wexner评分≤9分时,女性FIQL评分结果低于男性(P<0.05),在Wexner评分>9分时,除了生活方式上差异无统计学意义(P>0.05)外,其余均显示男性得分高于女性(P<0.05)。EQ-5D评分结果显示男性和女性在焦虑和抑郁维度上差异有统计学意义(P=0.024)。EQ-5D指数表明,女性的健康状况明显比男性差,差异有统计学意义(P=0.002)。Cox回归分析显示,Wexner评分、性别、年龄、焦虑或抑郁都是肛门失禁生活质量评分量表的影响因素。结论性别是影响肛门失禁患者生活质量的重要因素,对女性生活质量的影响大于男性,生活质量的测量应该作为病情评估和治疗的一部分。Objective To evaluate and compare quality of life of fecal incontinence patients with different gender. Methods Retrospective analysis of 61 patients with fecal incontinence in our hospital from January 2013 to January 2016.Anorectal manometry and rectal endoscopic ultrasound examination were used to evaluated the pathophysiology of fecal incontinence.Using Wexner and Vaizey score scale to assess the severity of clinical symptoms,using anal incontinence （FIQL） or EuroQol （EQ-5D） to evaluate the quality of life of patients,and analyze the data with statistical software. Results A total of 61 patients met the inclusion criteria,the cases with pelvic radiotherapy or low rectal resection in patients had significant difference between male and female （ P 〈0.05）.94.3% of women and 50.0% of men with sphincter dysfunction,42.3% of men and 71.4 % of women had damaged the internal sphincter,the differences were significant （ P 〈0.05）,decreased rectal sensitivity was more in male.When Wexner score less than or equal to 9 points,FIQL score in the women was lower than men （ P 〈0.05）,and Wexner score more than 9 points,the dimension was significant difference except the way of life.The results showed that anxiety or depression dimension of EQ-5D score had significant difference （ P = 0.024 ）.EQ-5D index data showed that women′s health was significant worse than men （ P = 0.002 ）.Cox regression analysis showed that Wexner score,gender,age and anxiety or depression were influencing factors of FIQL score. Conclusion Gender is one of the important factors affect the anus incontinence patients quality of life,of which the quality of life score in women is higher.The quality of life measurement should be as a part of the condition assessment and treatment.

关 键 词：肛门失禁 性别 生活质量 

分 类 号：R604[医药卫生—外科学]