Vallès Margarita, Mearin Fermín
Unidad de Rehabilitación Funcional Digestiva, Institut Guttmann, Universidad Autónoma de Barcelona, Barcelona, Spain.
Gastroenterol Hepatol. 2012 May;35(5):330-6. doi: 10.1016/j.gastrohep.2011.11.014. Epub 2012 Jan 31.
Loss of bowel control is distressing for persons with a medullary lesion and affects their quality of life. The present study aims to provide an updated review of the topic. Impaired neural control of continence and defecation after a medullary lesion provokes bowel dysfunction, with a high prevalence of two main symptoms: fecal incontinence and constipation. The physiopathology of these disorders is correlated with the neurological characteristics of the lesion, and various physiopathologic patterns have been established that correlate with the clinical manifestations. Evaluation of bowel dysfunction in these patients is normally exclusively clinical and complementary examinations are rarely used, although they seem promising. Treatment is based on establishing a program of evacuation. However, despite correct application, the results can be unsatisfactory and consequently other therapeutic alternatives should be developed.
对于患有延髓病变的人来说，肠道控制功能丧失令人苦恼，并会影响他们的生活质量。本研究旨在对该主题进行最新综述。延髓病变后，控尿和排便的神经控制受损会引发肠道功能障碍，主要有两种症状的患病率很高：大便失禁和便秘。这些疾病的生理病理学与病变的神经学特征相关，并且已经建立了与临床表现相关的各种生理病理模式。对这些患者肠道功能障碍的评估通常仅为临床评估，很少使用辅助检查，尽管辅助检查似乎很有前景。治疗基于制定一个排便计划。然而，尽管应用正确，结果可能并不理想，因此应开发其他治疗选择。
