Rasmussen M M, Kutzenberger J, Krogh K, Zepke F, Bodin C, Domurath B, Christensen P
1] Pelvic Floor Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark [2] Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
Department of Neuro-Urology, Werner-Wicker-Klinik, Bad Wildungen-Reinhardhausen, Germany.
Spinal Cord. 2015 Apr;53(4):297-301. doi: 10.1038/sc.2015.2. Epub 2015 Jan 20.
Cross-sectional study.
To evaluate the long-term effect of the sacral anterior root stimulator (SARS) on neurogenic bowel dysfunction in a large, well defined spinal cord injury (SCI) cohort.
Department of Neuro-Urology, Bad Wildungen, Germany.
Subjects undergone surgery at for SARS-SDAF (sacral deafferentation) between September 1986 and July 2011 (n=587) answered a questionnaire. In total, 277 SARS subjects were available for the baseline (recall) and follow-up comparison.
Median age was 49 years (range: 19-80), time from SCI to surgery was 10 years (range: 0-49) and from surgery to follow-up 13 (range: 1-25). Of the responders 73% used SARS for bowel emptying. On visual analog scale (VAS) ranging from 0-10 (best), satisfaction with SARS was 10. Baseline and follow-up comparison showed a decline in the median VAS score 0-10 (worst) for bowel symptoms from 6 (range: 4-8) to 4 (range: 2-6), P<0.0001; median neurogenic bowel dysfunction score from 17 (range: 11-2) to 11 (range: 9-15), P<0.0001; median St Marks score from 4 (range: 0-7) to 4 (range: 0-5), P=0.01; and median Cleveland constipation score from 7 (range: 6-10) to 6 (range: 4-8), P<0.0001. Use of suppositories, digital evacuation and mini enema and subjects totally dependent on assistance during defecation were significantly lower after SARS.
The SARS has the potential to be one of the few treatment methods targeting multiple organ dysfunctions following SCI.
横断面研究。
在一个大型、明确界定的脊髓损伤（SCI）队列中，评估骶前根刺激器（SARS）对神经源性肠道功能障碍的长期影响。
德国巴特维尔东根神经泌尿外科。
1986年9月至2011年7月间接受SARS-SDAF（骶去传入神经术）手术的受试者（n = 587）回答了一份问卷。共有277名SARS受试者可用于基线（回顾）和随访比较。
中位年龄为49岁（范围：19 - 80岁），从SCI到手术的时间为10年（范围：0 - 49年），从手术到随访的时间为13年（范围：1 - 25年）。在应答者中，73%使用SARS进行肠道排空。在0至10分（最佳）的视觉模拟量表（VAS）上，对SARS的满意度为10分。基线和随访比较显示，肠道症状的中位VAS评分从0至10分（最差）的6分（范围：4 - 8分）降至4分（范围：2 - 6分），P < 0.0001；中位神经源性肠道功能障碍评分从17分（范围：11 - 22分）降至11分（范围：9 - 15分），P < 0.0001；中位圣马克评分从4分（范围：0 - 7分）降至4分（范围：0 - 5分），P = 0.01；中位克利夫兰便秘评分从7分（范围：6 - 10分）降至6分（范围：4 - 8分），P < 0.0001。使用栓剂、手指辅助排便和小灌肠剂以及排便时完全依赖协助的受试者在接受SARS治疗后显著减少。
SARS有可能成为针对SCI后多器官功能障碍的少数治疗方法之一。
