Chou Q, Weber A M, Piedmonte M R
Department of Gynecology and Obstetrics, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Obstet Gynecol. 2000 Oct;96(4):599-603. doi: 10.1016/s0029-7844(00)00955-8.
To characterize preoperative signs and symptoms in women with and without enteroceles.
Three hundred ten women completed preoperative questionnaires and had prolapses graded according to the International Continence Society system. Signs and symptoms in 77 women (25%) with enteroceles confirmed at surgery were compared with those in 233 women without enteroceles. Comparisons were tested for statistical significance with chi(2) tests, Fisher exact tests, Wilcoxon rank-sum tests, and analysis of covariance.
Women with enteroceles were statistically significantly older (median 67 versus 59 years, P <.001) and more likely to be postmenopausal (88% versus 76%, P =.04). More women with enteroceles had histories of hysterectomies (76% versus 39%, P =.001) and vaginal prolapse repairs (24% versus 11%, P =.008). Women with enteroceles had more advanced prolapses at points Ap, Bp, and C (all P <.001) but not point D. There were no significant differences in symptoms related to bowel function (infrequent bowel movements, straining, manual evacuation, and fecal incontinence) in women with and without enteroceles. Women with enteroceles were more bothered by symptoms caused by vaginal prolapse than women without enteroceles, but not after we controlled for stage of prolapse.
Women with enteroceles have more advanced apical and posterior vaginal prolapses than women without enteroceles, but do not differ from them in bowel function.
描述有和没有小肠膨出的女性术前的体征和症状。
310名女性完成了术前问卷调查，并根据国际尿失禁协会系统对脱垂进行分级。将手术中确诊为小肠膨出的77名女性（25%）的体征和症状与233名没有小肠膨出的女性的体征和症状进行比较。采用卡方检验、Fisher精确检验、Wilcoxon秩和检验和协方差分析对比较结果进行统计学显著性检验。
有小肠膨出的女性在统计学上年龄显著更大（中位数67岁对59岁，P<.001），且更有可能处于绝经后（88%对76%，P=.04）。有小肠膨出的女性中有更多人有子宫切除史（76%对39%，P=.001）和阴道脱垂修复史（24%对11%，P=.008）。有小肠膨出的女性在Ap、Bp和C点的脱垂程度更严重（均P<.001），但在D点无差异。有和没有小肠膨出的女性在与肠道功能相关的症状（排便次数少、用力排便、手法辅助排便和大便失禁）方面没有显著差异。有小肠膨出的女性比没有小肠膨出的女性更受阴道脱垂引起的症状困扰，但在控制脱垂阶段后则无差异。
有小肠膨出的女性比没有小肠膨出的女性有更严重的阴道顶部和后部脱垂，但在肠道功能方面与她们没有差异。
