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脊髓磁刺激对老年慢性便秘患者的疗效。

Efficacy of spinal magnetic stimulation in elderly persons with chronic constipation.

机构信息

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2012 Mar;75(3):127-31. doi: 10.1016/j.jcma.2012.02.004. Epub 2012 Mar 9.

Abstract

BACKGROUND

The development of primary constipation in elderly adults usually has a multifactorial etiology. Slow transit constipation and pelvic floor dysfunction (PFD) are the two most commonly seen constipation subtypes in the elderly. PFD is usually a persistent condition that remains unresponsive to treatment in spite of various therapies currently available to relieve constipation. The aim of this study was to assess the usefulness of spinal magnetic stimulation (SMS) in controlling intractable constipation in elderly patients.

METHODS

Nineteen patients over the age of 65 with intractable constipation were enrolled in this study, and participated in a 12-session magnetic conditioning protocol consisting of a 20-minute stimulation session once daily. Colonic transit time (CTT) and the dynamics of evaluation as revealed in defecography were measured, and the Knowles-Eccersley-Scott Symptom (KESS) Questionnaire was administered before the intervention, and after finishing the protocol.

RESULTS

There was a statistically significant improvement in CTT and defecography following the intervention. The difference in the anorectal angles between resting and evacuation (p = 0.001) and the changes in pelvic floor descent (p = 0.011) both reached significance after the intervention. The mean CTT (p = 0.001), Knowles-Eccersley-Scott Symptom score (p = 0.001), frequency of bowel movement (p = 0.005), unsuccessful evacuation (p = 0.018), and time needed for bowel hygiene (p = 0.032) all showed marked improvement after SMS conditioning.

CONCLUSION

Our findings reveal that SMS intervention may benefit elderly patients with severe constipation. The amelioration of geriatric bowel dysfunction across the subtypes of slow transit constipation and PFD indicated that SMS, featuring broad-spectrum applications, can be an effective form of adjuvant treatment in the care of elderly adults.

摘要

背景

老年人原发性便秘的发展通常具有多因素病因。慢传输型便秘和盆底功能障碍(PFD)是老年人中最常见的两种便秘亚型。PFD 通常是一种持续存在的病症,尽管目前有各种治疗方法可缓解便秘,但仍对治疗无反应。本研究旨在评估脊髓磁刺激(SMS)在控制老年患者难治性便秘中的作用。

方法

本研究纳入了 19 名年龄在 65 岁以上的难治性便秘患者,并参与了一项为期 12 次的磁调理方案,包括每天 20 分钟的刺激疗程。测量结肠传输时间(CTT)和排粪造影的动力学评估,并在干预前和完成方案后进行 Knowles-Eccersley-Scott 症状(KESS)问卷评估。

结果

干预后 CTT 和排粪造影均有统计学显著改善。干预后休息和排空时直肠肛管角的差异(p=0.001)和盆底下降的变化(p=0.011)均有显著意义。平均 CTT(p=0.001)、Knowles-Eccersley-Scott 症状评分(p=0.001)、排便频率(p=0.005)、排空失败(p=0.018)和排便卫生时间(p=0.032)均明显改善。

结论

我们的发现表明,SMS 干预可能有益于严重便秘的老年患者。SMS 对慢传输型便秘和 PFD 各亚型的改善表明,SMS 具有广泛的应用范围,可作为老年患者护理的有效辅助治疗形式。

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