van Kuyk E M, Wissink-Essink M, Brugman-Boezeman A T, Oerlemans H M, Nijhuis-van der Sanden M W, Severijnen R S, Festen C, Bleijenberg G
Department of Medical Psychology, University Medical Centre Nijmegen, The Netherlands.
J Pediatr Surg. 2001 Sep;36(9):1350-6. doi: 10.1053/jpsu.2001.26368.
BACKGROUND/PURPOSE: The most frequent consequences of being born with an anorectal malformation (ARM) are problems with fecal continence and constipation, which can have various negative implications. In this prospective, controlled study the effect of multidisciplinary behavioral treatment dealing with these problems is evaluated.
The effect of multidisciplinary behavioral treatment was studied in 24 children (15 boys, 9 girls; mean age 5.8 years). Thirteen children were allocated to the treatment condition. The 11 children allocated to the waiting list control group also were treated after a waiting period of 6 months. Children underwent follow-up after treatment.
Compared with a waiting list control group, the experimental treatment group scores significantly better on 2 important measures ("Templeton," "Percentage of feces in toilet"). Although young children had poorer scores than older children before treatment, no significant differences in the favorable outcome of treatment were found between both groups after treatment. No effect of type of ARM on treatment was found either. The results of multidisciplinary behavioral treatment remain stable over a mean follow-up period of 7 months.
Multidisciplinary behavioral treatment is an important and valuable supplement to the standard medical treatment of children born with ARM suffering from chronic defecation problems.
背景/目的：先天性肛门直肠畸形（ARM）最常见的后果是大便失禁和便秘问题，这些问题可能产生各种负面影响。在这项前瞻性对照研究中，评估了多学科行为治疗对这些问题的效果。
对24名儿童（15名男孩，9名女孩；平均年龄5.8岁）进行了多学科行为治疗效果的研究。13名儿童被分配到治疗组。分配到等待名单对照组的11名儿童在等待6个月后也接受了治疗。治疗后对儿童进行随访。
与等待名单对照组相比，实验治疗组在两项重要指标（“邓普顿”，“马桶内粪便百分比”）上的得分明显更高。虽然治疗前幼儿的得分比大龄儿童低，但治疗后两组在治疗良好结果方面没有发现显著差异。也未发现肛门直肠畸形类型对治疗有影响。多学科行为治疗的结果在平均7个月的随访期内保持稳定。
对于患有慢性排便问题的先天性肛门直肠畸形儿童，多学科行为治疗是标准药物治疗的重要且有价值的补充。
