Bowel function and quality of life after minimally invasive colectomy with D3 lymphadenectomy for right-sided colon adenocarcinoma

BACKGROUND Changes in bowel function after right-sided colectomy are not well understood compared to those associated with left-sided colectomy or rectal resection.In particular,there are concerns about bowel function after right-sided colectomy with complete mesocolic excision,which has become popular in the West.AIM To evaluate the functional outcomes of patients who underwent right-sided colectomy with D3 lymphadenectomy for colon cancer.METHODS Functional data from patients who underwent minimally invasive right-sided colectomy for colon cancer from October 2017 to September 2018 were prospectively collected.Functional outcomes were evaluated preoperatively and at 3,6,12,and 18 mo postoperatively.RESULTS Prior to surgery,57 patients answered the questionnaire,and 47 responded at three months,52 at 6 mo,52 at 12 mo,and 25 at 18 mo postoperatively.Most scales of quality of life and bowel function improved significantly over time.Urgency persisted to a high degree throughout the period without a significant change over time.The use of medications for defecation was about 10%over the entire period.Gas(P=0.023)and fecal frequency(P<0.001)increased,and bowel dysfunction group(P=0.028)was more common among patients taking medication.At six months,resected bowel and colon lengths were significantly different as a risk factor between the dysfunction group and the no dysfunction group[odd ratio(OR):1.095,P=0.026;OR:1.147,P=0.031,respectively]in univariate analysis,but not in multivariate analysis.CONCLUSION Despite D3 lymphadenectomy,most bowel symptoms improved over time after right-sided colectomy using a minimally invasive approach,and continuous medication was needed in only approximately 10%of patients.

Colonic pouch confers better bowel function and similar postoperative outcomes compared to straight anastomosis for low rectal cancer

BACKGROUND With advancements in laparoscopic technology and the wide application of linear staplers,sphincter-saving procedures are increasingly performed for low rectal cancer.However,sphincter-saving procedures have led to the emergence of a unique clinical disorder termed anterior rectal resection syndrome.Colonic pouch anastomosis improves the quality of life of patients with rectal cancer>7 cm from the anal margin.But whether colonic pouch anastomosis can reduce the incidence of rectal resection syndrome in patients with low rectal cancer is unknown.AIM To compare postoperative and oncological outcomes and bowel function of straight and colonic pouch anal anastomoses after resection of low rectal cancer.METHODS We conducted a retrospective study of 72 patients with low rectal cancer who underwent sphincter-saving procedures with either straight or colonic pouch anastomoses.Functional evaluations were completed preoperatively and at 1,6,and 12 mo postoperatively.We also compared perioperative and oncological outcomes between two groups that had undergone low or ultralow anterior rectal resection.RESULTS There were no significant differences in mean operating time,blood loss,time to first passage of flatus and excrement,and duration of hospital stay between the colonic pouch and straight anastomosis groups.The incidence of anastomotic leakage following colonic pouch construction was lower(11.4%vs 16.2%)but not significantly different than that of straight anastomosis.Patients with colonic pouch construction had lower postoperative low anterior resection syndrome scores than the straight anastomosis group,suggesting better bowel function(preoperative:4.71 vs 3.89,P=0.43;1 mo after surgery:34.2 vs 34.7,P=0.59;6 mo after surgery:22.70 vs 29.0,P<0.05;12 mo after surgery:15.5 vs 19.5,P=0.01).The overall recurrence and metastasis rates were similar(4.3%and 11.4%,respectively).CONCLUSION Colonic pouch anastomosis is a safe and effective procedure for colorectal reconstruction after low and ultralow rectal resections.Moreover,colonic pouch construction may provide better functional outcomes compared to straight anastomosis.

Effects of cereal fiber on bowel function: A systematic review of intervention trials

AIM: To comprehensively review and quantitatively summarize results from intervention studies that examined the effects of intact cereal dietary fiber on parameters of bowel function. METHODS: A systematic literature search was conducted using Pub Med and EMBASE. Supplementary literature searches included screening reference lists from relevant studies and reviews. Eligible outcomes were stool wet and dry weight, percentage water in stools, stool frequency and consistency, and total transit time. Weighted regression analyses generated mean change(± SD) in these measures per g/d of dietary fiber. RESULTS: Sixty-five intervention studies among generally healthy populations were identified. A quantitative examination of the effects of non-wheat sources of intact cereal dietary fibers was not possible due to an insufficient number of studies. Weighted regression analyses demonstrated that each extra g/d of wheat fiber increased total stool weight by 3.7 ± 0.09 g/d(P < 0.0001; 95%CI: 3.50-3.84), dry stool weight by 0.75 ± 0.03 g/d(P < 0.0001; 95%CI: 0.69-0.82), and stool frequency by 0.004 ± 0.002 times/d(P = 0.0346; 95%CI: 0.0003-0.0078). Transittime decreased by 0.78 ± 0.13 h per additional g/d(P < 0.0001; 95%CI: 0.53-1.04) of wheat fiber among those with an initial transit time greater than 48 h.CONCLUSION: Wheat dietary fiber, and predominately wheat bran dietary fiber, improves measures of bowel function.

Efficacy of a Kiwifruit Extract (PhenActivTM) on Gastrointestinal Tract Function: A Randomised Double-Blind Placebo-Controlled Study

Objective: Gastrointestinal (GI) discomfort is experienced by millions of people every day. This study aimed to evaluate the effect of PhenActivTM, a novel green kiwifruit extract, on gastrointestinal tract (GIT) function in otherwise healthy adults. Methods: 41 healthy adults with mild GI discomfort were enrolled in this double-blind, randomized, placebo-controlled study. Participants were randomized to either take 3.0 g/day of PhenActivTM or a placebo for 6 weeks. Interviews were conducted at baseline, week 3 and week 6, with participants completing questionnaires regarding GI symptoms. Frequency of bowel movements was self-recorded daily. Results: There were no differences in daily and weekly defecation frequency and stool characteristics in either group. The active and placebo groups significantly improve GSRS scores (p , only the active group had a significant improvement in the IBSSS and PAC-QOL scores (p < 0.05) from baseline. Neither group had changes in sleep quality, quality of life and fatigue, plasma zonulin concentrations or macular pigment optical density scores. The product was well tolerated with no GI disturbances or adverse events being reported. Conclusion: Supplementation of 3.0 g/day of PhenActivTM for 6 weeks did not improve defecation frequency or stool composition in healthy adults, but did improve perceived symptoms of GIT function, including symptoms of functional GIT disorders, IBS and constipation. The product was well tolerated and future trials investigating higher doses with more participants and/or a different population would be beneficial.

Irritable bowel syndrome and functional constipation management with integrative medicine: A systematic review

BACKGROUND Irritable bowel syndrome(IBS)and functional constipation(FC)are two commonly encountered functional gastrointestinal disorders in clinical practice and are usually managed with Western medicines in cooperation with traditional Chinese medicine(TCM)interventions.Although clinical practice guidelines(CPGs)have been developed to assist clinicians with their decisions,there are still gaps in management with regard to integrative medicine(IM)recommendations.AIM To comprehensively review the currently available CPGs and to provide a reference for addressing the gaps in IBS and FC management.METHODS We searched mainstream English and Chinese databases and collected data from January 1990 to January 2019.The search was additionally enriched by manual searches and the use of publicly available resources.Based on the development method,the guidelines were classified into evidence-based(EB)guidelines,consensus-based(CB)guidelines,and consensus-based guidelines with no comprehensive consideration of the EB(CB-EB)guidelines.With regard to the recommendations,the strength of the interventions was uniformly converted to a 4-point grading scale.RESULTS Thirty CPGs met the inclusion criteria and were captured as data extraction sources.Most Western medicine(WM)CPGs were developed as EB guidelines.All TCM CPGs and most IM CPGs were identified as CB guidelines.Only the 2011 IBS and IM CPG was a CB-EB set of guidelines.Antispasmodics and peppermint oil for pain,loperamide for diarrhea,and linaclotide for constipation polyethylene glycol and lactulose as osmotic laxatives,bisacodyl and sodium picosulfate as stimulant laxatives,lubiprostone and linaclotide as prosecretory agents,and prucalopride were strongly recommended or recommended in FC.TCM interventions were suggested based on pattern differentiation,while the recommendation level was considered to be weak or insufficient.CONCLUSION WM CPGs generally provide a comprehensive management algorithm,although there are still some gaps that could be addressed with TCM.Specific high-quality trials are needed to enrich the evidence.

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Inflammatory bowel disease(IBD) patients in remission may suffer from gastrointestinal symptoms that resemble irritable bowel syndrome(IBS). Knowledge on this issue has increased considerably in the last decade, and it is our intention to review and summarize it in the present work. We describe a problematic that comprises physiopathological uncertainties, diagnostic difficulties, as IBS-like symptoms are very similar to those produced by an inflammatory flare, and the necessity of appropriate management of these patients, who, although in remission, have impaired quality of life. Ultimately, from almost a philosophical point of view, the presence of IBS-like symptoms in IBD patients in remission supposes a challenge to the traditional functional-organic dichotomy, suggesting the need for a change of paradigm.

Effect of 5-HT1 agonist (sumatriptan) on anorectal function in irritable bowel syndrome patients

瞄准：评估 sumatriptan 的效果，选择 5-HT1 收缩筋，在在急躁的肠症候群(IBS ) 的肛门直肠的功能上病人。方法：根据罗马 II 标准选择的 22 个 IBS 病人(F 15， M 7；吝啬的年龄 29.3+/-6.8，范围 22-44 年) 被检验。学习是盲目的，使随机化并且与一个转线路图案控制安慰剂。肛门直肠的测压法和直肠的汽球扩张测试在安慰剂和 sumatriptan 的管理前后被执行。结果：从 9.2+/-2.0 kPa 在休息肛管压力引起重要增加到 13.1+/-3.3 kPa (P【0.0001 ) 的 sumatriptan 的管理随肛门括约肌长度和高压力地区的增加连接了。在 sumatriptan 注射以后，为到 34+/-12 mL (P【0.05 ) 的从 27+/-9 mL 的第一种感觉和到 68+/-18 mL (P【0.01 ) 的从 61+/-19 mL 的冲动感觉的阀值的显著增加被观察。Sumatriptan 也没影响唤起肛门禁止的反射或拉紧的结果测试的书籍的右页的体积。结论：5-HT1 受体参予肛门直肠的功能的规定。在 IBS 的 pathophysiological 机制的 5-HT1 受体的角色的说明可以有一些治疗学的含意。

Investigation of the effect of military stress on the prevalence of functional bowel disorders

AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seven soldiers who were assigned to specified services and 471 soldiers who were assigned to routine services were enrolled using cluster sampling, with the latter as a control group. They were surveyed using the Rome Ⅲ FBD standard questionnaire. The FBD symptom question-naire included FBD-related symptoms, severity, dura- tion or attack time, and accompanying symptoms. RESULTS: The morbidity of the military stress group (14.6%) was significantly higher than in the control group (9.98%) ( 2 = 4.585, P < 0.05). The incidence of smoking, abdominal pain and acid regurgitation ( 2 = 4.761, P < 0.05) as well as the ZUNG anxiety/depression scores ( 2 = 7.982, P < 0.01) were also sig- nificantly higher in the military stress group compared with the control group. ZUNG anxiety ( 2 = 11.523, P < 0.01) and depression ( 2 = 5.149, P < 0.05) scores were higher in the FBD group compared with the non-FBD group. The differences in the ZUNG self-rated anxiety and depression scales between the 2 groups were statistically significant ( 2 = 14.482, P < 0.01 and 2 = 6.176, P < 0.05). CONCLUSION: The morbidity of FBD was higher under military stress conditions.

Patients with functional bowel disorder have disaccharidase deficiency:A single-center study from Russia

BACKGROUND Functional bowel disorder(FBD)may be caused by a decrease in disaccharidase activity.Thus,the timely diagnosis of disaccharidase deficiency could lead to a better prognosis in patients with this condition.AIM To determine the potential value of intestinal disaccharidases glucoamylase,maltase,sucrase,and lactase in understanding the etiology and pathogenesis of FBD.METHODS A total of 82 FBD patients were examined.According to the Rome IV criteria(2016),23 patients had diarrhea-predominant irritable bowel syndrome(IBS),33 had functional diarrhea,10 had constipation-predominant IBS,4 had functional constipation,and 12 had mixed IBS.The Dahlqvist method was used to measure disaccharidase activity in the brush-border membrane of mature enterocytes of the small intestine,in duodenal biopsies obtained during esophagogastroduodenoscopy.RESULTS Lactase deficiency was detected in 86.5%of patients,maltase deficiency in 48.7%,sucrase deficiency in 50%,and glucoamylase deficiency in 84.1%.The activities of all enzymes were reduced in 31.7%of patients,and carbohydrase deficiency was detected in 63.5%of patients.The low activity of enzymes involved in membrane digestion in the small intestine was found in 95.2%of patients.CONCLUSION In 78 of the 82 patients with FBD,gastrointestinal symptoms were associated with disaccharidase deficiency.

Functional dyspepsia and irritable bowel syndrome,are they different entities and does it matter?

在机能性消化不良和急躁的肠症候群之间的重叠的高流行一致地并且普遍被报导了。表明包括的分享的普通 pathophysiological 骚乱的最近的研究推迟了胃的倒空和包含超过一个区域的内脏的超敏性，建议这些病人有一广义而非地区性，内脏的混乱。而且，消化不良的自然科学的研究建议与时间，一个实质的比例将演变为 IBS。在消化不良的病人的 IBS 的识别有潜在地深刻的治疗学的重要性。它能帮助在 IBS 病人减少不必要的胆囊炎的风险。欣赏参与的程度的能力能允许我们更包括地探讨骚乱，并且从而与他们的治疗完成更大的耐心的满足。

Diets, functional foods, and nutraceuticals as alternative therapies for inflammatory bowel disease: Present status and future trends

Inflammatory bowel disease(IBD) is a serious health concern among western societies. The disease is also on the rise in some East Asian countries and in Australia. Health professionals and dietitians around the world are facing an unprecedented challenge to prevent and control the increasing prevalence of IBD. The current therapeutic strategy that includes drugs and biological treatments is inefficient and are associated with adverse health consequences. In this context, the use of natural products is gaining worldwide attention. In vivo studies and clinical evidence suggest that wellplanned dietary regimens with specific nutrients can alleviate gastrointestinal inflammation by modulating inflammatory cytokines, such as tumor necrosis factor α(TNF-α), interleukin 1(IL-1), IL-6, IL-1β, and IL-10. Alternatively, the avoidance of high-fat and highcarbohydrate diets is regarded as an effective tool to eliminate the causes of IBD. Many functional foods and bioactive components have received attention for showing strong therapeutic effects against IBD. Both animal and human studies suggest that bioactive functional foods can ameliorate IBD by downregulating the pro-inflammatory signaling pathways, such as nuclear factor κB, STAT1, STAT6, and pro-inflammatory cytokines, including IL-1β, IL-4, IL-6, COX-2, TNF-α, and interferon γ. Therefore, functional foods and diets have the potential to alleviate IBD by modulating the underlying pathogenic mechanisms. Future comprehensive studies are needed to corroborate the potential roles of functional foods and diets in the prevention and control of IBD.

A New Immunofluorescence Assay for Fecal Calprotectin Distinguishes Inflammatory Bowel Disease from Functional Bowel Disease

Aims: To investigate the diagnostic value of fecal calprotectin (FC) determined by a new immunofluorescence assay-fluorescence enzyme immunoassay (FEIA) in patient with inflammatory bowel disease (IBD) or functional bowel disease, compared with the typical ELISA kit. Methods: FC was determined simultaneously by FEIA and an ELISA kit in 26 patients with functional bowel disease and 77 patients with IBD. We compared the difference of FC levels between patients with IBD and patients with functional bowel disease. Receiver operating characteristics curve (ROC) was constructed to obtain the optimal cut-off value of FC for distinguishing IBD from functional bowel disease and the corresponding sensitivity and specificity. Results: The median FC levels of patients with IBD in clinical active stage or clinical remission stage was significantly higher than that of patients with functional bowel disease. The median FC levels of patients with IBD in clinical active stage, IBD in clinical remission stage and functional bowel disease were as follow: 699.91 (346.14 ~ 1647.54) μg/g;407.36 (121.81 ~ 878.48) μg/g;39.04 (12.09 ~ 81.04) μg/g when FC was measured by FEIA. The median FC levels were 716.99 (240.42 ~ 1232.53) μg/g;338.46 (53.08 ~ 692.82) μg/g;41.44 (11.77 ~ 73.19) μg/g among such above three groups of patients respectively, when FC was measured by ELISA kit. The diagnostic value of IBD with FC determined by FEIA (optimal cut-off = 131.79 μg/g) and ELISA kit (optimal cut-off = 121.85 μg/g) presented an area under the curve of 0.881 and 0.873, respectively. Conclusions: FC determined by FEIA was an accurate surrogate marker to distinguish IBD from functional bowel disease.

Five-year follow-up of 263 cases of functional bowel disorder

AIM: To determine the mortality associated with functional bowel disorders (FBDs) and their possible relationship with organic bowel disease. METHODS: Patients who satisfied the Rome Ⅲ criteria for FBD (retrospective diagnosis) were followed up by telephone interview and/or outpatient review at 5 years after their first attendance. The patients were divided into the following groups: irritable bowel syndrome, functional abdominal bloating, functional constipation, functional diarrhea and unspecified FBD. The survival of the FBD patients overall and of those with each FBD were compared with data obtained from the Guangzhou population in 2005. The incidences of colonic cancer overall and for each FBD were compared with data from the Chinese population obtained from 56 cancer registries in 19 provinces of the country in 2008. RESULTS: Two hundred and sixty-three patients were followed-up. Five patients died, which was not significantly different from the expected survival rate. No differences in mortality among the FBDs were found. There were nine cases of organic bowel disease: three colonic cancers and six colonic polyps. The incidence of colonic cancer in FBD patients was higher than that in the general Chinese population (0.23% vs 0.03%, P < 0.05). There were significant differences in the incidence of colonic cancer among the FBDs (0/134, 0/24, 2/29, 1/66, 0/10, respectively, P<0.05); functional constipation was the most common. The incidence of colonic polyps was similar among the FBDs. The baseline age of patients who died was greater than that of those who survived (66.60±6.84 years vs 45.14±10.34 years, P<0.05). The baseline age of patients who had colonic cancer or polyps during follow-up was greater than that of those without colonic cancer or polyps (60.33±1.53 years vs 45.38±10.62 years; 54.50±6.47 years vs 45.34±10.68 years, P<0.05). CONCLUSION: FBDs do not increase the risk of death. The incidence of colonic cancer in patients with FBDs may be increased, especially in those with functional constipation and in the elderly.

The Correlation between Sexuality and Family Functioning among Patients with Inflammatory Bowel Disease in Japan

Purpose: The objective of this study was to examine the correlation between the sexuality of patients with Inflammatory Bowel Disease and family functioning. Methods: The study took the form of a self-administered questionnaire survey, utilizing the Sexuality Satisfaction Index for IBD (SEXSI-IBD) for measuring sexuality and the Survey of Family Environment Survey of Family Environment (SFE) for measuring family functioning. SEXSI-IBD consists of 28 items and five domains, and SFE consists of 30 items and five domains. The participants were recruited at 15 self-help groups and 14 hospitals. Results: Of 146 participants, 48.6% were male and 52.4% female, with an average age of 41.1 years. A significant correlation was observed between the item average score of SEXSI-IBD and Overall Satisfaction Score (OSS) of SFE. Significant correlations were observed in two domains of the SEXSI-IBD, “Daily interaction” and “Sexual communication,” and in all five domains of the SFE. In particular, for “Daily interaction,” the strongest correlation was observed in the SFE’s “Macro system” and “Family internal environment system.” A correlation was observed between the “Physical contact importance” in SEXSI-IBD and the “Macro system” in the OSS of the SFE. Conclusions: Sexuality correlates with family functioning not only in the family internal environment system but also in the family external environment system. Through an approach aimed at elevating the degree of satisfaction for sexuality, it becomes possible to improve family functioning and realize a sense of family well-being.

Management of Overlap Syndrome between Functional Dyspepsia and Irritable Bowel Syndrome by Western and Traditional Chinese Medicine

The overlap syndrome of functional dyspepsia and irritable bowel syndrome (FD-IBS) is very common and difficult to treat. There are many risk factors of FD-IBS. Mental illness of FD-IBS patients is more serious. Functional dyspepsia and irritable bowel syndrome have some similarities in the aspects of pathophysiology, pathogenesis, and treatment. We should pay attention to two aspects of the treatment of overlap syndrome, one is simplifying medications, the other is using gastrointestinal motility drug with bidirectional regulative function when necessary. Traditional Chinese medicine in this respect shows some advantages. This review addresses the epidemiology, risk factors, clinical features, pathogenesis and management of FD-IBS.

慢性避水应激法建立大鼠肠易激综合征模型及其评价

目的:探讨慢性避水应激(WAS)法建立肠易激综合征(IBS)大鼠模型的方法,并评价其可行性。方法:30只雄性清洁型Wistar大鼠,随机分为对照组(n=10)和模型组(n=20),模型组大鼠每日采用WAS法诱导1 h,连续干预造模10 d;对照组大鼠不进行任何干预。造模结束后,观察并记录2组大鼠一般情况和体质量,采用高架十字迷宫(EPM)实验检测2组大鼠进入开放臂次数(OE)百分率和进入开放臂时间(OT)百分率,腹壁撤回反射(AWR)实验检测2组大鼠内脏敏感性,心电图检查2组大鼠心率变异性(HRV),腹外斜肌肌电图(EMG)检测2组大鼠结直肠痛敏阈值,多通道生理信号记录仪检测2组大鼠结肠慢波频率。结果:2组大鼠在整个造模期间均无死亡情况,造模结束后,模型组大鼠均伴有精神状态欠佳、自主活动减少、少动、皮毛散乱且无光泽、易激惹和肛门口不净等情况;对照组大鼠精神状态、自主活动、皮毛和肛周无明显变化。与对照组比较,模型组大鼠体质量明显降低(P<0.05)。EPM实验,与对照组比较,模型组大鼠OE百分率和OT百分率均明显降低(P<0.01)。AWR实验,模型组中AWR半定量评分≥3分大鼠共12只,内脏痛大鼠模型造模成功率为60%。与对照组比较,模型组大鼠低频信号(LF)和LF/高频信号(HF)比值均明显升高(P<0.01),HF明显降低(P<0.05)。EMG法,与对照组比较,模型组大鼠结肠痛敏阈值明显降低(P<0.01),结肠慢波频率明显升高(P<0.01)。结论:采用WAS法建立IBS大鼠模型,大鼠行为及精神情绪改变、内脏敏感性升高、结肠慢波频率加快和自主神经系统平衡性紊乱,WAS法可作为一种有效的造模方式,用于观察和评价IBS治疗的相关药物及干预方法。

电针“天枢”与“天枢”配伍“上巨虚”对肠易激综合征大鼠行为学和结肠功能的影响

目的观察并比较电针“天枢”与“天枢”配伍“上巨虚”对肠易激综合征(irritable bowel syndrome,IBS)模型大鼠情绪和结肠功能影响,初步探讨天枢配伍上巨虚是否存在协同或叠加效应。方法雄性Wistar大鼠分为空白组(10只)和造模组(45只),采用慢性和急性应激相结合方法连续干预10 d制备模型,将制备成功IBS模型大鼠随机分为模型组(8只)、天枢组(8只)、天枢配伍上巨虚组(8只);天枢组、天枢配伍上巨虚组连续电针干预治疗14 d;干预结束后,分别对各组大鼠进行高架十字迷宫实验、结肠痛敏阈值测定,检测血清5-羟色胺(5-hydroxytryptamine,5-HT)含量以及结肠5-羟色胺4受体(5-hydroxytryptamine 4 receptor,5-HT 4 R)蛋白表达。结果与模型组比较,电针天枢组、电针天枢配伍上巨虚组进入开放臂(open arm entry,OE)次数百分比和开臂停留时间(open arm time,OT)百分比增加(P<0.01);结肠痛敏阈值显著升高(P<0.01);血清5-HT含量减少(P<0.05);结肠5-HT 4 R蛋白相对表达量增加(P<0.05)。两电针组之间比较,OE%、OT%、结肠痛敏阈值、血清5-HT含量以及结肠5-HT 4 R蛋白相对表达量的差异无统计学意义。结论电针“天枢”与“天枢”配伍“上巨虚”均能调节大鼠情绪心理行为的异常和改善结肠功能紊乱症状,但电针“天枢”配伍“上巨虚”相较于电针“天枢”未表现明显的穴位协同或叠加效应。

脊髓损伤神经源性肠道功能障碍患者经肛门灌洗的效果

目的探讨经肛门灌洗在脊髓损伤神经源性肠道功能障碍患者中的应用效果。方法将80例脊髓损伤后肠道功能障碍患者按住院先后顺序分为对照组(40例)和干预组(40例);对照组实施常规肠道管理方案,干预组在常规护理基础上使用简易工具进行经肛门灌洗。结果两组各有39例完成全程研究。干预后干预组腹胀发生率及排便频率得分显著低于对照组(均P<0.05)。结论经肛门灌洗可有效减轻脊髓损伤后肠功能障碍患者腹胀、排便频率异常等肠道症状,改善患者肠道功能。

机器学习在胃肠疾病神经影像研究中的应用进展

目前,胃肠疾病发病率居高不下,常见的胃肠病有肠易激综合征、功能性消化不良、炎症性肠病等,严重影响患者的身心健康。基于肠-脑轴的神经机制为寻找与胃肠疾病相关的新型标志物提供了新思路。近年来,基于MRI的胃肠疾病神经机制研究备受关注,同时有研究者尝试利用机器学习方法对其影像数据进行分析和解读,在加深对胃肠疾病神经机制的理解方面取得了不错的效果。本文重点概述了机器学习方法在与胃肠疾病相关的MRI神经影像中的应用情况,旨在为深入探索胃肠疾病的神经机制提供参考,并为提高胃肠疾病的诊断和预后评估效能等方面提供新思路、新手段。

低位直肠癌保肛术后行早期排便功能训练护理模式对肛门功能的影响分析

目的 研究早期排便功能训练护理模式应用在低位直肠癌保肛术后患者的临床可行性,并深入探究有无影响肛门功能。方法 通过计算机1:1随机数列方式对本院2021年5月—2023年6月收治的低位直肠癌保肛术后患者82例均分两组。其中,参照组(n=41)采用常规护理,研究组(n=41)采用早期排便功能训练护理模式,比较护理后的效果。结果 研究组护理后的排便功能优良率以及护理工作满意度评分较参照组高,组间差异有统计学意义(P<0.05)。护理质量评分方面,研究组心理护理、训练干预、专业技术和护理中心等分值较参照组高,组间差异有统计学意义(P<0.05)。护理前两组患者的SAS评分和SDS评分对比,差异无统计学意义(P>0.05);护理后研究组SAS评分和SDS评分较参照组低,组间差异有统计学意义(P<0.05)。结论 低位直肠癌保肛术后患者选取科学有效的护理方法至关重要,其中早期排便功能训练护理模式对肛门功能的恢复具有积极的效果,护理工作满意度以及护理质量均明显提高,不良心理得到显著改善,具有较高的可行性。