Choi You Jin, Seo Bo Seon, Lee Jun Ho, Jeong Su Jin
Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea.
Neurourol Urodyn. 2017 Feb;36(2):490-494. doi: 10.1002/nau.22963. Epub 2016 Feb 1.
The investigation of fecal retention using objective and patient-friendly tools, rather than the diagnosis of constipation, might be important in the management of overactive bladder (OAB) in children. The present study aimed to evaluate the incidence and grade of fecal retention in children with OAB and to determine the effectiveness of laxative treatment for fecal retention in the management of OAB in children.
This study included 88 children with OAB aged 5-15 years. Fecal retention was defined as type 1/2 feces (Bristol stool form scale) or a Leech score above eight points, and constipation was determined according to the ROME III criteria. Among the 88 children, 71 with fecal retention or constipation were treated with oral laxatives (polyethylene glycol 3,350/4,000 or lactulose) for 2 weeks, and the responses to the treatment were assessed.
Among the 88 children, 63 (71.6%) had a Leech score above eight points as assessed by plain abdominal radiography, 52 (59.1%) had type 1/2 feces (Bristol stool form scale), 24 (27.3%) had functional constipation and only 6 (6.8%) had none of either. Among the 71 children who received laxative treatment for 2 weeks, 58 (81.7%) reported an improvement in OAB symptoms. Additionally, the number of children with a Leech score above eight points was significantly higher in the good response group than in the poor response group (P = 0.014).
Investigation of fecal retention with the Leech scoring system and laxative treatment might be helpful in the management of OAB in children. Neurourol. Urodynam. 36:490-494, 2017. © 2016 Wiley Periodicals, Inc.
使用客观且患者友好的工具来研究粪便潴留,而非便秘的诊断,这在儿童膀胱过度活动症(OAB)的管理中可能很重要。本研究旨在评估OAB患儿中粪便潴留的发生率和分级,并确定泻药治疗粪便潴留对儿童OAB管理的有效性。
本研究纳入了88名5至15岁的OAB患儿。粪便潴留定义为1/2型粪便(布里斯托大便分类法)或利兹评分高于8分,便秘根据罗马III标准确定。在这88名儿童中,71名有粪便潴留或便秘的儿童接受了口服泻药(聚乙二醇3350/4000或乳果糖)治疗2周,并评估了治疗反应。
在这88名儿童中,经腹部平片评估,63名(71.6%)利兹评分高于8分,52名(59.1%)为1/2型粪便(布里斯托大便分类法),24名(27.3%)有功能性便秘,只有6名(6.8%)两者均无。在接受2周泻药治疗的71名儿童中,58名(81.7%)报告OAB症状有所改善。此外,良好反应组中利兹评分高于8分的儿童数量显著高于不良反应组(P = 0.014)。
用利兹评分系统研究粪便潴留和泻药治疗可能有助于儿童OAB的管理。《神经泌尿学与尿动力学》36:490 - 494,2017年。© 2016威利期刊公司