Freeman Kurt A, Riley Andrew, Duke Danny C, Fu Rongwei
Division of Psychology, Institute on Development & Disability, Oregon Health & Science University and Department of Public Health and Preventative Medicine, Oregon Health & Science University
Division of Psychology, Institute on Development & Disability, Oregon Health & Science University and Department of Public Health and Preventative Medicine, Oregon Health & Science University.
J Pediatr Psychol. 2014 Sep;39(8):887-902. doi: 10.1093/jpepsy/jsu039. Epub 2014 Jun 12.
Multiple treatments exist for fecal incontinence. However, the relative and additive influence of commonly used behavioral approaches remains unclear.
We conducted a systematic review of randomized controlled trials to synthesize the effects of behavioral treatment of fecal incontinence with constipation in children aged 4-18 years. Mixed treatment comparisons (MTCs) and random effects models were used to analyze outcomes. Risk of bias and quality of evidence were rated.
Although 10 studies were identified for MTCs, results did not yield reliable or valid estimates. Four studies were retained for random effects pooled outcome analysis. Results indicated that behavioral intervention was more effective than control conditions for author-defined success and soiling frequency.
Although evidence supports behavioral treatments for fecal incontinence with constipation in children, available evidence is limited. More and higher-quality trials are needed to better understand the relative effects of different treatments, including behavioral strategies.
针对大便失禁存在多种治疗方法。然而，常用行为疗法的相对影响和附加影响仍不明确。
我们对随机对照试验进行了系统评价，以综合4至18岁儿童大便失禁合并便秘的行为治疗效果。采用混合治疗比较（MTC）和随机效应模型分析结果。对偏倚风险和证据质量进行了评级。
尽管为MTC确定了10项研究，但结果未得出可靠或有效的估计值。保留了4项研究用于随机效应汇总结果分析。结果表明，行为干预在作者定义的成功和弄脏频率方面比对照条件更有效。
尽管有证据支持对儿童大便失禁合并便秘进行行为治疗，但现有证据有限。需要更多更高质量的试验，以更好地了解不同治疗方法（包括行为策略）的相对效果。
