Lehur Paul, Matzel Klaus, Baeten Cor, Lundby Lilli
Clinique de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Universitaire de Nantes, Frankrig.
Ugeskr Laeger. 2011 Apr 4;173(14):1056-8.
Faecal incontinence should primarily be managed in a conservative way, and if this is not sufficient different options for minimally invasive surgery should be considered. Dietary regimens, fibers, constipating agents, enemas, biofeedback and colonic irrigation may be tried as first-line therapy. Posterior tibial nerve stimulation and injections of bulging agents can be offered, but the evidence is still not convincing. Sacral nerve stimulation is a well documented treatment for faecal incontinence. Magnetic anal sphincter implantation should be considered only in highly selected patients.
大便失禁应首先采用保守方法进行处理,如果这种方法不够充分,则应考虑不同的微创手术选择。饮食方案、纤维、止泻剂、灌肠、生物反馈和结肠灌洗可作为一线治疗方法尝试。可以采用胫后神经刺激和注射膨胀剂,但证据仍不确凿。骶神经刺激是一种有充分文献记载的大便失禁治疗方法。仅在经过严格筛选的患者中才应考虑植入磁性肛门括约肌。