The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person’s life.Fecal incontinence is common,though it is often underreported by patients.In addition to standard treatmen...The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person’s life.Fecal incontinence is common,though it is often underreported by patients.In addition to standard treatment options,new treatments have been developed during the past decade to attempt to effectively treat fecal incontinence with minimal morbidity.Non-operative treatments include dietary modifications,medications,and biofeedback therapy.Currently used surgical treatments include repair(sphincteroplasty),stimulation(sacral nerve stimulation or posterior tibial nerve stimulation),replacement(artificial bowel sphincter or muscle transposition)and diversion(stoma formation).Newer augmentation treatments such as radiofrequency energy delivery and injectable materials,are minimally invasive tools that may be good options before proceeding to surgery in some patients with mild fecal incontinence.In general,more invasive surgical treatments are now reserved for moderate to severe fecal incontinence.Functional and quality of life related outcomes,as well as potential complications of the treatment must be considered and the treatment of fecal incontinence must be individualized to the patient.General indications,techniques,and outcomes profiles for the various treatments of fecal incontinence are discussed in detail.Choosing the most effective treatment for the individual patient is essential to achieve optimal outcomes in the treatment of fecal incontinence.展开更多
目的:探讨生物反馈治疗功能性便秘的远期疗效及护理对策.方法:对150例接受生物反馈治疗治疗的功能性便秘患者进行回顾性随访,比较患者功能性便秘治疗前和随访时的临床症状和肛门直肠测压结果,评价功能性便秘治疗的远期疗效极其相关影响...目的:探讨生物反馈治疗功能性便秘的远期疗效及护理对策.方法:对150例接受生物反馈治疗治疗的功能性便秘患者进行回顾性随访,比较患者功能性便秘治疗前和随访时的临床症状和肛门直肠测压结果,评价功能性便秘治疗的远期疗效极其相关影响因素.结果:治疗后3 mo随访和6 mo随访时具有临床症状的人数比治疗前明显减少,差异具有统计学意义(P<0.05).治疗后患者的直肠静息压和最大缩窄压与治疗前相差不大,差异不具有统计学意义(P>0.05).而治疗后的初次排便感觉阈值和直肠肛门抑制反射阈值明显比治疗前降低(41.65 mL±6.74 mL vs 29.41 mL±4.97 mL,67.12 mL±9.55 mL vs 47.25 mL±8.34 mL),差异具有统计学意义(P<0.05).多因素分析结果显示,生物反馈治疗治疗的远期疗效与患者依从性和社会支持利用度正相关,与年龄、病程和基础性疾病呈负相关.结论:生物反馈治疗能改善功能性便秘患者临床症状,纠正生理功能障碍,具有较好的远期疗效.展开更多
基金Supported by Dr.Wexner is a consultant and receives consulting fees in the field of fecal incontinence from:Incontinence Devices,IncMediri Therapeutics,Inc.+2 种基金Medtronic Inc.Renew MedicalSalix Pharmaceuticals
文摘The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person’s life.Fecal incontinence is common,though it is often underreported by patients.In addition to standard treatment options,new treatments have been developed during the past decade to attempt to effectively treat fecal incontinence with minimal morbidity.Non-operative treatments include dietary modifications,medications,and biofeedback therapy.Currently used surgical treatments include repair(sphincteroplasty),stimulation(sacral nerve stimulation or posterior tibial nerve stimulation),replacement(artificial bowel sphincter or muscle transposition)and diversion(stoma formation).Newer augmentation treatments such as radiofrequency energy delivery and injectable materials,are minimally invasive tools that may be good options before proceeding to surgery in some patients with mild fecal incontinence.In general,more invasive surgical treatments are now reserved for moderate to severe fecal incontinence.Functional and quality of life related outcomes,as well as potential complications of the treatment must be considered and the treatment of fecal incontinence must be individualized to the patient.General indications,techniques,and outcomes profiles for the various treatments of fecal incontinence are discussed in detail.Choosing the most effective treatment for the individual patient is essential to achieve optimal outcomes in the treatment of fecal incontinence.
文摘目的:探讨生物反馈治疗功能性便秘的远期疗效及护理对策.方法:对150例接受生物反馈治疗治疗的功能性便秘患者进行回顾性随访,比较患者功能性便秘治疗前和随访时的临床症状和肛门直肠测压结果,评价功能性便秘治疗的远期疗效极其相关影响因素.结果:治疗后3 mo随访和6 mo随访时具有临床症状的人数比治疗前明显减少,差异具有统计学意义(P<0.05).治疗后患者的直肠静息压和最大缩窄压与治疗前相差不大,差异不具有统计学意义(P>0.05).而治疗后的初次排便感觉阈值和直肠肛门抑制反射阈值明显比治疗前降低(41.65 mL±6.74 mL vs 29.41 mL±4.97 mL,67.12 mL±9.55 mL vs 47.25 mL±8.34 mL),差异具有统计学意义(P<0.05).多因素分析结果显示,生物反馈治疗治疗的远期疗效与患者依从性和社会支持利用度正相关,与年龄、病程和基础性疾病呈负相关.结论:生物反馈治疗能改善功能性便秘患者临床症状,纠正生理功能障碍,具有较好的远期疗效.
