直肠前突修补术后 1 年的肠症状变化。
Changes in bowel symptoms 1 year after rectocele repair.
机构信息
Division of Urogynecology, Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, USA.
出版信息
Am J Obstet Gynecol. 2012 Nov;207(5):423.e1-5. doi: 10.1016/j.ajog.2012.06.054. Epub 2012 Jun 29.
OBJECTIVE
We sought to evaluate changes in bowel symptoms after rectocele repair and identify risk factors for persistent symptoms.
STUDY DESIGN
We conducted ancillary analysis of a randomized surgical trial for rectocele repair. Subjects underwent examinations and completed questionnaires for bowel symptoms at baseline and 12 months postoperatively. Outcomes included resolution, persistence, or de novo bowel symptoms. We used multiple logistic regression to identify risk factors for bowel symptom persistence.
RESULTS
A total of 160 women enrolled: 139 had baseline bowel symptoms and 85% had 12-month data. The prevalence of bowel symptoms decreased after rectocele repair (56% vs 23% splinting, 74% vs 37% straining, 85% vs 19% incomplete evacuation, 66% vs 14% obstructive defecation; P < .001 for all). On multiple logistic regression, a longer history of splinting was a risk factor for persistent postoperative splinting (adjusted odds ratio, 2.25; 95% confidence interval, 1.02-4.93).
CONCLUSION
Bowel symptoms may improve after rectocele repair, but almost half of women will have persistent symptoms.
目的
评估直肠前突修补术后肠症状的变化，并确定持续存在症状的危险因素。
研究设计
我们对直肠前突修补术的随机手术试验进行了辅助分析。受试者在基线和术后 12 个月接受检查和肠症状问卷。结局包括症状缓解、持续存在或新出现的肠症状。我们使用多变量逻辑回归来确定肠症状持续存在的危险因素。
结果
共有 160 名女性入组：139 名基线时有肠症状，85%有 12 个月的数据。直肠前突修补术后肠症状的发生率降低（排便时用手撑辅助 56% vs 23%，用力排便 74% vs 37%，排便不尽感 85% vs 19%，梗阻性排便 66% vs 14%；所有比较 P <.001）。多变量逻辑回归显示，排便时用手撑辅助的时间较长是术后持续存在排便时用手撑辅助的危险因素（调整后的优势比，2.25；95%置信区间，1.02-4.93）。
结论
直肠前突修补术后肠症状可能改善，但近一半的女性仍会持续存在症状。
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