老年尿失禁的診斷

Diagnosis of Urinary Incontinence in the Elderly

徐愫萱(Su-Hsuan Hsu) ； 賴秀昀(Hsiu-Yun Lai) ； 溫瓊容(Chiung-Jung Wen)

《長期照護雜誌》 13卷1期 (2009/04) Pp. 1-12

https://doi.org/10.6317/LTC.200904_13(1).0001

摘要

尿失禁是常見的老年症候群之一，其盛行率隨著年齡增長而增加，且以女性為多。尿失禁不僅在生理、心理及社會層面對病患造成影響，也使得照顧花費大幅提高。其往往是多重原因造成，隨年齡增加所產生的膀胱生理變化，以及年齡相關的各種疾病，都是老年人發生尿失禁的可能原因。尿失禁的危險因子包括：年齡、女性、多產次、種族、肥胖、多重疾病、認知功能異常、以及活動受限等。尿失禁可分為暫時性與持續性。暫時性尿失禁常由一些可矯正的因素所引起，且常伴隨下泌尿道異常，常見原因可用「DIAPPERS」做為口訣來記憶，一般針對可矯正因素治療後即可改善症狀。持續性尿失禁則可分為急迫性、應力性、滿溢性、功能性及混合性等五類。
針對尿失禁的老年病患應做的初步評估包括病史詢問、理學檢查、尿液檢查，以及排尿後殘餘尿量測量等，其餘檢查則視需要而定。大部分的尿失禁透過完整的病史詢問就可加以分類，再加上理學檢查及尿液檢查等，通常就足以提供初步治療的依據。

關鍵字

尿失禁 ； 老人 ； 老化 ； 診斷

並列摘要

Urinary incontinence is a common geriatric syndrome. The prevalence of urinary incontinence increases with age and is higher in women than men. Urinary incontinence affects physical health, psychological well-being, and social status. Health care expenditure also escalates. The etiology of urinary incontinence is multifactorial, such as physiological changes with aging bladder and age-related systemic diseases. The risk factors for urinary incontinence include age, female, multiparity, race, obesity, comorbid conditions, cognitive impairment, restricted mobility and etc. Urinary incontinence can be classified into two categories: transient and established incontinence. Transient incontinence is often caused by some reversible factors and usually accompanied with problems of lower urinary tract. ”DIAPPERS” is a useful mnemonic for the reversible contributors to transient incontinence. Generally, when the causes of transient incontinence are treated, the symptoms improve. Established incontinence can be classified into five major types: urge, stress, overflow, functional and mixed incontinence. The initial evaluation of urinary incontinence includes a history, a physical examination, a urinalysis, and a postvoid residual urine measurement. Other diagnostic studies are indicated in specific conditions. In most cases, the history, physical examination, and urinalysis are sufficient to classify the type of urinary incontinence and guide the initial therapy.

並列關鍵字

urinary incontinence ； elderly ； aging ； diagnosis