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经肛门灌洗在韩国脊髓损伤患者中的应用:一项 6 个月随访研究。

Application of transanal irrigation for patients with spinal cord injury in South Korea: a 6-month follow-up study.

机构信息

Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea.

出版信息

Spinal Cord. 2013 May;51(5):389-94. doi: 10.1038/sc.2012.171. Epub 2013 Jan 15.

Abstract

STUDY DESIGN

A 6-month follow-up study.

OBJECTIVES

To investigate the outcome of transanal irrigation (TAI) in patients with spinal cord injury (SCI) and to identify factors significantly related to clinical success.

SETTING

Survey for community-dwelling patients with SCI in South Korea.

METHODS

Between December 2010 and March 2012, TAI was initiated with 52 patients (41 men; age: 44.5±11.0 years) with neurogenic bowel dysfunction (NBD). At 1, 3 and 6 months after initiation, a telephone interview was conducted. Data were collected on patient-specific bowel management and TAI performance as a new procedure.

RESULTS

Only 18 patients (34%) used TAI for at least 6 months, which was a lower compliance rate than similar studies in some European countries. Relative to the compliant group, the noncompliant group contained a higher proportion of tetraplegia than paraplegia (P=0.031), and a higher proportion dependent on physical help (P=0.034). In all, 33 of the 52 patients (63.5%) complained of practical problems with the TAI procedure such as expulsion of the rectal catheter. Fifteen patients (28.8%) presented with adverse effects. The incidence of practical problems or adverse effects did not alter the frequency of patient-reported successful outcome.

CONCLUSION

Korean participants showed a relatively lower compliance rate with TAI. We conclude that TAI, combined with adequate patient instruction and physical assistance, has potential as a management tool for NBD in Korea.

摘要

研究设计

一项为期 6 个月的随访研究。

目的

调查经肛门灌洗(TAI)在脊髓损伤(SCI)患者中的疗效,并确定与临床成功显著相关的因素。

设置

韩国社区居住的 SCI 患者的调查。

方法

2010 年 12 月至 2012 年 3 月,对 52 名神经源性肠功能障碍(NBD)患者(41 名男性;年龄:44.5±11.0 岁)启动 TAI。启动后 1、3 和 6 个月进行电话访谈。收集患者特定的肠道管理和 TAI 作为新程序的执行情况。

结果

只有 18 名患者(34%)至少使用 TAI 6 个月,这一依从率低于一些欧洲国家的类似研究。与依从组相比,不依从组四肢瘫痪的比例高于截瘫(P=0.031),且更多地依赖于身体帮助(P=0.034)。在所有 52 名患者中,有 33 名(63.5%)对 TAI 程序提出了实际问题,如直肠导管排出。15 名患者(28.8%)出现不良反应。实际问题或不良反应的发生率并未改变患者报告成功结果的频率。

结论

韩国参与者对 TAI 的依从率相对较低。我们得出结论,TAI 结合充分的患者指导和身体帮助,可能成为韩国 NBD 的管理工具。

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