Leong A F, Yunos A B
Department of Surgery, National University Hospital, Singapore.
Ostomy Wound Manage. 1999 Nov;45(11):52-6.
People with ostomies in Singapore were initially resistant to colostomy irrigation. This study, a prospective crossover study of 26 patients who underwent abdominoperineal resection, compared colostomy irrigation with the natural evacuation method. During the colostomy-irrigation phase of the study, all 26 patients reported an improvement in continence and fewer problems with sleep, sex, and skin complications compared to the natural-evacuation phase. The study also found a reduction in monthly expenses with colostomy irrigation compared to natural evacuation. Patient satisfaction scores were also superior during the colostomy-irrigation phase. This difference in satisfaction scores was less marked in those who were more than 1-year postsurgery than in those who were less than 1-year postsurgery. The difference in satisfaction between colostomy irrigation and natural evacuation scores was statistically significant in the group that was less than 1-year postsurgery, but not in the group that was more than 1-year postsurgery. The study concluded that colostomy irrigation after abdominoperineal resection is superior to natural evacuation in terms of cost and patient satisfaction and should be introduced soon after surgery.
新加坡造口患者最初对结肠造口灌洗持抵触态度。本研究是一项对26例行腹会阴切除术患者的前瞻性交叉研究，比较了结肠造口灌洗与自然排便法。在研究的结肠造口灌洗阶段，与自然排便阶段相比，所有26例患者均报告控便能力有所改善，睡眠、性生活及皮肤并发症问题减少。研究还发现，与自然排便相比，结肠造口灌洗的每月费用有所降低。结肠造口灌洗阶段的患者满意度评分也更高。术后超过1年的患者，满意度评分的差异不如术后不到1年的患者明显。结肠造口灌洗与自然排便评分之间的满意度差异在术后不到1年的组中具有统计学意义，但在术后超过1年的组中无统计学意义。研究得出结论，腹会阴切除术后的结肠造口灌洗在成本和患者满意度方面优于自然排便，应在术后尽早采用。
