骶神经调节术治疗慢性便秘与排粪失禁的研究进展

Research progress of sacral neuromodulation procedure in the treatment of chronic constipation and fecal incontinence

骶神经调节术（SNM）是一种治疗便秘与排粪失禁的新术式。相对传统手术而言，它具有手术操作简单、创伤小、安全等优点，且主要用于经保守治疗失败的患者。慢性便秘是最常见的消化道症状之一，便秘严重的患者，生活质量明显下降。国内的排粪失禁发病率虽不及便秘高，却也严重地影响了患者的生活。虽然目前SNM治疗便秘和排粪失禁的具体作用机制尚未明确，但随着研究的深入，对SNM的认识越来越深刻，其效果已得到认可。SNM治疗改善患者症状并提高生活质量的文献报道也越来越多，逐渐开始在结直肠手术后进行SNM治疗的尝试，并发现肠道功能障碍也得到了改善。然而，该术式在国内尚未普及，也鲜有SNM治疗便秘与排粪失禁的报道，国内学者对于SNM的了解亦不甚多。故本文就SNM治疗慢性便秘与排粪失禁的作用机制和方法、手术步骤、有效性、并发症和术后禁忌证及需要特别注意的人群等研究进展做一综述，以期为国内SNM治疗的提供参考。

Sacral neuromodulation （SNM） procedure has become a new therapy to treat chronic constipation and fecal incontinence. The surgical procedure is easy and safe. It has a small incision compared with traditional surgery and is mainly used in patients whose traditional treatment was unsuccessful. Chronic constipation is one of the most common digestive symptoms. The quality of life in patients with severe constipation has decreased greatly. Although the incidence of fecal incontinence in China is not as high as that of constipation, it also seriously affects the life of the patients, resulting in a decline in the quality of life. Although the mechanism of SNM is uncertain, with more studies conducted, understanding has become more profound, and the curative effect has been recognized. SNM can improve the symptoms and the quality of life. Many studies have reported SNM treatment. Furthermore, some trials on SNM have been conducted. It is used after colorectal resections to promote symptoms of bowel dysfunction. However, few studies reported regarding SNM for constipation and fecal incontinence in China, and knowledge regarding SNM is limited. In this article, we will mainly discuss SNM in the treatment of chronic constipation and fecal incontinence, and its research progress on the mechanism and method, surgical procedure, effectiveness, complications, postoperative contraindications, and the population who need to pay attention, in order to provide reference for the treatment of SNM in China.