Clarke Melanie C C, Chase Janet W, Gibb Susie, Catto-Smith Anthony G, Hutson John M, Southwell Bridget R
Surgical Research Group, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, 3052, Australia.
Pediatr Surg Int. 2009 Jun;25(6):473-8. doi: 10.1007/s00383-009-2372-4. Epub 2009 May 16.
Slow transit constipation (STC) is a form of chronic constipation characterised by prolonged passage of faecal matter through the colon. It is diagnosed by demonstrating delayed colonic transit on gastrointestinal transit studies. Traditionally, radio-opaque marker studies are performed. Recently, radioisotope nuclear transit studies (NTS) have been used in our centre to assess gastrointestinal transit time. This study aimed to evaluate if there are changes in colonic transit in STC children resistant to standard medical treatment over a prolonged period.
Children with STC resistant to standard medical therapy for > or =2 years who had undergone two separate NTS to assess their colonic transit (where the first study had identified slow colonic transit without anorectal retention) were identified after ethical approval. The geometric centre (GC) of radioisotope activity at 6, 24, 30 and 48 h was compared in the two transit studies to determine if changes occurred.
Seven children (4 males) with proven STC resistant to standard medical therapy and two transit studies performed at different times were identified. Mean age was 7.0 years (5.4-10.8 years) at first study, and 11.4 years (9.7-14.2 years) at second study, with a mean of 4.4 years (1-8.5 years) between studies. There was no significant difference in colonic transit at any timepoint in the two tests (paired t test).
We conclude that nuclear transit studies are reproducible in assessing slow colonic transit in children with treatment-resistant STC and demonstrate that conventional medical treatment over many years has no effect on underlying colonic motility.
慢传输型便秘（STC）是一种慢性便秘形式，其特征是粪便在结肠内通过时间延长。通过胃肠传输研究中显示结肠传输延迟来进行诊断。传统上采用不透X线标志物研究。最近，我们中心已使用放射性核素核传输研究（NTS）来评估胃肠传输时间。本研究旨在评估长期对标准药物治疗无效的STC儿童的结肠传输是否存在变化。
在获得伦理批准后，确定那些对标准药物治疗无效≥2年且已接受两次独立NTS以评估其结肠传输的STC儿童（第一次研究已确定结肠传输缓慢且无肛门直肠潴留）。比较两次传输研究中6、24、30和48小时放射性核素活性的几何中心（GC），以确定是否发生变化。
确定了7名（4名男性）经证实对标准药物治疗无效的STC儿童，并进行了两次不同时间的传输研究。第一次研究时的平均年龄为7.0岁（5.4 - 10.8岁），第二次研究时为11.4岁（9.7 - 14.2岁），两次研究间隔平均为4.4年（1 - 8.5年）。两次测试在任何时间点的结肠传输均无显著差异（配对t检验）。
我们得出结论，核传输研究在评估对治疗有抵抗性STC儿童的结肠传输缓慢方面具有可重复性，并表明多年的传统药物治疗对潜在的结肠动力没有影响。
