Suppr超能文献

大便失禁:评估与治疗的实用方法

Fecal incontinence: a practical approach to evaluation and treatment.

作者信息

Soffer E E, Hull T

机构信息

Department of Gastroenterology and Colorectal Surgery, The Cleveland Clinic Foundation, Ohio, USA.

出版信息

Am J Gastroenterol. 2000 Aug;95(8):1873-80. doi: 10.1111/j.1572-0241.2000.02237.x.

Abstract

Fecal incontinence is a common problem and can have a major impact on the quality of life of those affected. Various disease processes affecting stool consistency, rectal sensitivity, or the anal sphincters can cause fecal incontinence. Obstetric trauma is now known to be a major cause of sphincter dysfunction. The evaluation of the patient with incontinence helps to determine the choice of therapy-medical or surgical. The two most important tests are anorectal manometry, which provides information on sphincter pressures, and rectal sensation, and anal endosonography, which is currently the test of choice for defining the anatomy of the anal sphincters. The choice of therapy depends on the etiology of incontinence, the anatomy of the sphincters, and also on the effect of incontinence on the quality of life of the patient. Control of diarrhea, regardless of the cause, should be attempted first. Biofeedback therapy is effective in the majority of patients and is particularly attractive because it is safe and well tolerated. Surgery is offered when medical therapy is unsuccessful or when the etiology is thought to respond best to surgery, such as in postobstetric trauma. Sphincter repair, for treatment of selective sphincter defects, is the best surgical option. Neoanal sphincters and implanted artificial sphincters are far less attractive because of technical difficulties and low success rate.

摘要

大便失禁是一个常见问题,会对受影响者的生活质量产生重大影响。影响大便稠度、直肠敏感性或肛门括约肌的各种疾病过程都可能导致大便失禁。现在已知产科创伤是括约肌功能障碍的主要原因。对失禁患者的评估有助于确定治疗方法的选择——药物治疗还是手术治疗。两项最重要的检查是肛门直肠测压法,它可提供有关括约肌压力和直肠感觉的信息,以及肛门腔内超声检查,它目前是用于确定肛门括约肌解剖结构的首选检查。治疗方法的选择取决于失禁的病因、括约肌的解剖结构,还取决于失禁对患者生活质量的影响。无论病因如何,应首先尝试控制腹泻。生物反馈疗法对大多数患者有效,而且因其安全且耐受性良好而特别有吸引力。当药物治疗不成功或病因被认为对手术反应最佳时,如产科创伤后,可考虑手术治疗。括约肌修复术用于治疗选择性括约肌缺陷,是最佳的手术选择。由于技术困难和成功率低,新型肛门括约肌和植入式人工括约肌的吸引力要小得多。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验