學術論壇
學術論壇可提供瀏覽者及一般會員閱讀瀏覽學術文章。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 阮雍順 | 減重12到18個月對於肥胖女性的尿失禁問題是否有影響 | 2011/2/20 下午 06:35:30 | 0 |
| 原 文 | 題 目 | Effect of Weight Loss on Urinary Incontinence in Overweight and Obese Women: Results at 12 and 18 Months |
| 作 者 | Rena R. Wing, Delia Smith West, Deborah Grady等人 | |
| 出 處 | Journal of Urology | |
| 出版日期 | 2010, September, Vol 184, page 1005-1010 | |
| 評 論 |
尿失禁會嚴重的影響到婦女的生活品質，而一些流行病學的研究也指出肥胖是造成婦女尿失禁的重要危險因子，但是目前仍然缺乏有效的證據證實減肥能改善婦女尿失禁的頻率與嚴重度。作者在2009年曾在新英格蘭雜誌發表減肥6個月確實能減少47%的每週尿失禁次數，而且主要改善的是應力性尿失禁；但減重12到18個月是否也可以維持這麼好的結果呢？本文作者就再一次對於肥胖婦女做了一系列的研究。 他們將336位平均身體質量指數（body mass index，BMI）36±6 kg/m2的肥胖婦女，分為減重組以及控制組(非減重組)，然後在減重後6個月、12個月以及18個月後分別以七天的解尿日誌來評估尿失禁的情況。結果發現減重的比例分別是在6個月達到-8.0%, 12個月-7.5% 以及18個月-5.5%，隨著時間的增加似乎並沒有增加減重的效果。但是在改善尿失禁的比例上，減重6個月能減少47%的每週總尿失禁次數, 減重12個月可改善57%的每週總尿失禁次數而減重18個月可改善62%的每週總尿失禁次數。但是對控制組(非減重組)而言，18個月後每週總尿失禁次數也有55%的改善；所以結果上控制組與減重組在18個月後包括每週總尿失禁次數以及應力性尿失禁次數上都無明顯的差異；顯示減重的效果對於尿失禁的影響隨著時間的增加而減弱。 雖然減重的效果對於尿失禁的影響隨著時間的增加而減弱，但是仍不失為處理尿失禁的第一線方法。在臨床上對於過度肥胖的婦女仍可以先建議改變生活與飲食習慣，減少體重的增加。畢竟肥胖不只會增加尿失禁的次數以及嚴重度，更是健康的大敵啊!! |
|
| abstract |
Purpose: Initial weight loss improves urinary incontinence in overweight and obese women. In this study we examined the longer term effects of a weight loss intervention on urinary incontinence. Materials and Methods: Overweight and obese women (mean±SD age 53±10 years) with 10 or more urinary incontinence episodes weekly were randomized to an 18-month behavioral weight loss intervention (226) or control group (112). Outcome measures were collected at 12 and 18 months. Results: At baseline women had a mean body mass index of 36±6 kg/m2 and reported a mean of 24±18 incontinence episodes weekly. Of the patients 86% completed 18-month measurements. The percent weight loss in the intervention group averaged 8.0%, 7.5% and 5.5% at 6, 12 and 18 months, respectively, vs approximately 1.5% in the control group (all values p <0.001). Compared with controls at 12 months the intervention group reported a greater percent reduction in weekly stress urinary incontinence episodes (65% vs 47%, p <0.001), and a greater proportion achieved at least a 70% decrease in weekly total and stress urinary incontinence episodes. At 18 months a greater proportion of women in the weight loss intervention group had more than 70% improvement in urge incontinence episodes but there were no significant differences between the groups for stress or total urinary incontinence. The intervention group also reported greater satisfaction with changes in urinary incontinence than the control group at 6, 12 and 18 months. Conclusions: Weight loss intervention reduced the frequency of stress incontinence episodes through 12 months and improved patient satisfaction with changes in incontinence through 18 months. Improving weight loss maintenance may provide longer term benefits for urinary incontinence. |
|
| 回覆發表 | 回覆討論主題內容 | 最後發表 |
| 目前尚無任何相關的回覆資料 | ||