Munck J, Simoens Ch, Thill V, Smets D, Debergh N, Fievet F, Mendes da Costa P
Department of Digestive, Laparoscopic and Thoracic Surgery, C.H.U. Brugmann, U.L.B., Brussels, Belgium.
Hepatogastroenterology. 2008 Nov-Dec;55(88):2125-9.
BACKGROUND/AIMS: Among spinal cord injury patients, digestive disorders are frequent, chronic, and progressive. Constipation and fecal incontinence, the most common disorders, can severely affect the quality of life of patients with spinal cord injury (SCI).
For this retrospective study, we reviewed the medical records of spinal cord injury patients with an intestinal stoma formation and developed a questionnaire to assess patient quality of life. Between January 1, 1996, and December 31, 2005, 10 SCI patients had a stoma formation for constipation, 10 for wound management, and 3 for other causes. Most of these stomas were performed by laparoscopy, with no postoperative mortality.
Postoperative morbidity was 26% at the general level, with a rate of 4% at the local level; morbidity reached 56% at longer follow-up. The average period of bowel dysfunction was 7.2 years. The average time per week spent on bowel management (bowel care and defecation time) was 6 h prior to stoma formation, but decreased to 1.5 h afterwards. Half of the questionnaire respondents reported an improved quality of life.
A left colostomy is an effective and safe alternative for anorectal disorders among SCI patients. For a large percentage of patients, it ensures an improved quality of life.
背景/目的:在脊髓损伤患者中,消化系统紊乱很常见,呈慢性且进行性发展。便秘和大便失禁是最常见的紊乱情况,会严重影响脊髓损伤(SCI)患者的生活质量。
对于这项回顾性研究,我们查阅了有肠造口形成的脊髓损伤患者的病历,并编制了一份问卷来评估患者的生活质量。在1996年1月1日至2005年12月31日期间,10名SCI患者因便秘进行了造口形成手术,10名因伤口处理进行手术,3名因其他原因进行手术。这些造口大多通过腹腔镜进行,无术后死亡病例。
总体术后发病率为26%,局部发病率为4%;随访时间延长后发病率达56%。肠道功能障碍的平均时长为7.2年。造口形成前每周用于肠道管理(肠道护理和排便时间)的平均时长为6小时,但之后降至1.5小时。一半的问卷受访者报告生活质量有所改善。
左半结肠造口术是SCI患者肛门直肠疾病的一种有效且安全的替代方法。对于很大一部分患者来说,它能确保生活质量得到改善。