van Kuyk E M, Brugman-Boezeman A T, Wissink-Essink M, Oerlemans H M, Severijnen R S, Bleijenberg G
Department of Medical Psychology, University Medical Centre Nijmegen, The Netherlands.
Acta Paediatr. 2001 Oct;90(10):1153-9. doi: 10.1080/080352501317061567.
Constipation, faecal incontinence, soiling and difficult toilet training remain significant problems in children with Hirschsprung's disease after corrective surgery. Chronic defecation problems can have various negative implications. At the University Medical Centre Nijmegen, a multidisciplinary behavioural treatment was developed to treat defecation problems. In this paper, a prospective controlled study is presented concerning the effect of this treatment upon children suffering from chronic defecation problems following corrective surgery for Hirschsprung's disease. The effect of treatment was studied in 27 children (21M, 6F, mean age 5.2y, range 2-11 y). Fourteen children were allocated to the experimental treatment group. The 13 children allocated to the waiting-list control group were also treated following a waiting period of 6 mo. On all outcome variables, children in the experimental treatment group had significantly better results after treatment than children in the waiting-list control group after the waiting period. No effect of age upon treatment was found. The effect of treatment remained significant on all outcome variables at a mean follow-up of 7 mo after the end of treatment.
Multidisciplinary behavioural treatment is successful in decreasing chronic defecation problems in children with Hirschsprung's disease.
便秘、大便失禁、便污及如厕训练困难仍是先天性巨结肠症患儿矫正手术后的重大问题。慢性排便问题会产生各种负面影响。奈梅亨大学医学中心开发了一种多学科行为疗法来治疗排便问题。本文介绍了一项前瞻性对照研究，探讨该疗法对先天性巨结肠症矫正手术后患有慢性排便问题的儿童的疗效。对27名儿童（21名男性，6名女性，平均年龄5.2岁，范围2至11岁）的治疗效果进行了研究。14名儿童被分配到实验治疗组。分配到等待名单对照组的13名儿童在等待6个月后也接受了治疗。在所有结局变量上，实验治疗组儿童治疗后的结果显著优于等待名单对照组儿童在等待期后的结果。未发现年龄对治疗有影响。治疗结束后平均随访7个月时，治疗效果在所有结局变量上仍显著。
多学科行为疗法成功减少了先天性巨结肠症患儿的慢性排便问题。
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