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首次急性脑卒中后第一周内恢复尿失禁的脑卒中患者比持续性下尿路功能障碍患者预后更好。

Stroke patients who regain urinary continence in the first week after acute first-ever stroke have better prognosis than patients with persistent lower urinary tract dysfunction.

机构信息

Institute of Clinical Neurophysiology, Division of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia.

出版信息

Neurourol Urodyn. 2011 Sep;30(7):1315-8. doi: 10.1002/nau.21013. Epub 2011 Apr 12.

Abstract

AIMS

Urinary incontinence (UI) is a predictor of greater mortality and poor functional recovery; however published studies failed to evaluate lower urinary tract (LUT) function immediately after stroke. The aim of our study was to evaluate the course of LUT function in the first week after stroke, and its impact on prognosis.

METHODS

We included 100 consecutively admitted patients suffering first-ever stroke and evaluated them within 72 hours after stroke, after 7 days, 6 months, and 12 months. For LUT function assessment we used ultrasound measurement. The patients were divided into three groups: (i) patients who remained continent after stroke, (ii) patients who had LUT dysfunction in the acute phase but regained continence in the first week, and (iii) patients who did not regain normal LUT control in the first week. We assessed the influence of variables on death using the multiple logistic regression model.

RESULTS

Immediately after stroke 58 patients had LUT dysfunction. The odds of dying in group with LUT dysfunction were significantly larger than odds in group without LUT dysfunction. Odds for death for patients who regained LUT function in 1 week after stroke were comparable to patients without LUT dysfunction.

CONCLUSIONS

We confirmed that post-stroke UI is a predictor of greater mortality at 1 week, 6 months and 12 months after stroke. However, patients who regain normal bladder control in the first week have a comparable prognosis as the patients who do not have micturition disturbances following stroke.

摘要

目的

尿失禁(UI)是死亡率更高和功能恢复不良的预测因素;然而,已发表的研究未能评估中风后即刻的下尿路(LUT)功能。我们研究的目的是评估中风后第一周 LUT 功能的变化及其对预后的影响。

方法

我们纳入了 100 例连续入院的首次中风患者,并在中风后 72 小时内、第 7 天、第 6 个月和第 12 个月对他们进行评估。为了评估 LUT 功能,我们使用了超声测量。将患者分为三组:(i)中风后仍保持控尿的患者;(ii)急性 LUT 功能障碍但在第一周内恢复控尿的患者;(iii)在第一周内未恢复正常 LUT 控制的患者。我们使用多因素逻辑回归模型评估变量对死亡的影响。

结果

中风后立即有 58 例患者存在 LUT 功能障碍。LUT 功能障碍组的死亡几率明显大于无 LUT 功能障碍组。在中风后一周内恢复 LUT 功能的患者的死亡几率与无 LUT 功能障碍的患者相当。

结论

我们证实中风后 UI 是 1 周、6 个月和 12 个月后死亡率更高的预测因素。然而,在第一周内恢复正常膀胱控制的患者与中风后没有排尿障碍的患者具有相似的预后。

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