Christiansen John
Kirurgisk Speciallaegeklinik, København.
Ugeskr Laeger. 2008 Nov 17;170(47):3867-70.
An analysis of the treatment of faecal incontinence in a surgical specialist practice with a particular interest in this disorder.
From May 2003 to December 2005, a total of 61 patients, 49 women and 12 men with a median age of 72 and 67 years, respectively, were referred for diagnosis and treatment of faecal incontinence. The median Wexner incontinence score was 11 and median quality of life score, on a visual analogue scale ranging from 0 to 10, was 5. Treatment included surgical correction of recto-anal mucosal prolapse and grade 3 to 4 haemorrhoids, medical treatment and sphincter training. Patients were followed-up by a questionnaire after a median period of 23 months (range: 18-31).
Six patients were immediately referred for hospital treatment. Ten patients in whom the result of conservative treatment was unsatisfactory were referred for treatment in specialized colorectal departments after 3-11 months. A total of 41 of the 45 patients returned the questionnaire. The median Wexner incontinence score fell from 11 to 5 (p < 0,01) and the median quality of life score dropped from 5 to 2 (p < 0,01). A total of 38 of the 51 patients who underwent conservative treatment were satisfied with the result and did not request referral to hospital for further treatment (75%; 95% confidence limit: 60-86).
Patients suffering from a moderate degree of faecal incontinence which is not obviously of traumatic origin, including childbirth, may be treated conservatively with a satisfactory result in a surgical specialist practice with special interest in this disorder.
对某外科专科诊所中粪便失禁治疗情况的分析，该诊所对这一病症尤为关注。
2003年5月至2005年12月，共有61例患者因粪便失禁前来诊断和治疗，其中49例女性，12例男性，年龄中位数分别为72岁和67岁。韦克斯纳失禁评分中位数为11分，生活质量评分中位数（采用0至10分的视觉模拟量表）为5分。治疗方法包括直肠肛管黏膜脱垂和3至4级痔疮的手术矫正、药物治疗及括约肌训练。患者在中位随访期23个月（范围：18 - 31个月）后通过问卷调查进行随访。
6例患者立即被转诊至医院治疗。10例保守治疗效果不佳的患者在3至11个月后被转诊至结直肠专科进行治疗。45例患者中有41例返回了问卷。韦克斯纳失禁评分中位数从(11)降至(5)（(p < 0.01)），生活质量评分中位数从(5)降至(2)（(p < 0.01)）。51例接受保守治疗的患者中有38例对治疗结果满意，未要求转诊至医院进一步治疗（(75%)；(95%)置信区间：(60 - 86%)）。
对于非明显创伤性起源（包括分娩）的中度粪便失禁患者，在对该病症有特殊兴趣的外科专科诊所中可进行保守治疗，且效果令人满意。
