Rintala R J
Hospital for Children and Adolescents, University of Helsinki, Finland.
Semin Pediatr Surg. 2002 May;11(2):75-82. doi: 10.1053/spsu.2002.31805.
In the majority cases, fecal soiling in children is functional and usually associated with severe constipation. Fortunately, functional soiling is a self-limiting problem and usually disappears at puberty. Organic fecal incontinence is a consequence of congenital malformations affecting the anorectum, anal sphincters, or the spinal cord. Inability to control bowel function may be permanent, as in patients with myelodysplasia; self-limiting, as in patients who have fecal soiling after a pull-through operation for Hirschsprung's disease; or partial, as in many patients who have undergone repair of an anorectal malformation. The purpose of this report is to review the etiology, long-term outcome, and evolution of the management of different types of organic fecal incontinence in children. Knowledge of the pathophysiology of fecal incontinence has accumulated during recent decades, and this provides the basis of modern treatment modalities that have revolutionized treatment so that today most patients can be provided total or at least social continence from early childhood.
在大多数情况下，儿童大便失禁是功能性的，通常与严重便秘有关。幸运的是，功能性大便失禁是一个自限性问题，通常在青春期消失。器质性大便失禁是影响肛门直肠、肛门括约肌或脊髓的先天性畸形的结果。无法控制排便功能可能是永久性的，如脊髓发育不良患者；自限性的，如患有先天性巨结肠症的患者在拖出手术后出现大便失禁；或部分性的，如许多接受过肛门直肠畸形修复手术的患者。本报告的目的是回顾儿童不同类型器质性大便失禁的病因、长期预后及治疗进展。近几十年来，对大便失禁病理生理学的认识不断积累，这为现代治疗方法提供了基础，这些方法彻底改变了治疗方式，使如今大多数患者从幼儿期就能实现完全或至少是社会意义上的控便。
