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使用经过验证的神经源性肠功能障碍评分表对小儿群体中的Peristeen®经肛门冲洗系统进行前瞻性评估。

Prospective evaluation of Peristeen® transanal irrigation system with the validated neurogenic bowel dysfunction score sheet in the pediatric population.

作者信息

Kelly Maryellen S, Dorgalli Crystal, McLorie Gordon, Khoury Antoine E

机构信息

Department of Urology, Duke University Medical Center, Durham, North Carolina.

Children's Hospital of Orange County, Pediatric Urology Center, Orange, California.

出版信息

Neurourol Urodyn. 2017 Mar;36(3):632-635. doi: 10.1002/nau.22979. Epub 2016 Feb 16.

Abstract

AIMS

To determine the ability of Peristeen® transanal irrigation system to reduce symptoms of neurogenic bowel dysfunction (NBD) in patients using the validated neurogenic bowel dysfunction scoring system for the pediatric population.

METHODS

Patients 3-21 years with NBD whose current bowel program was unsuccessful were given the Neurogenic Bowel Dysfunction (NBoDS) score sheet before initiating Peristeen®, and at 2 weeks, 2 months, and 6 months after. All patients were started on Peristeen® with tap water (20 ml/kg) per daily irrigation. Mean and paired t-tests were completed.

RESULTS

24 patients were enrolled and had follow-up. Mean age was 10.5 years (range 3-21 years), 25%, 50%, 25% had thoracic, lumbar and sacral level lesions respectively. Mean NBoDS score at initiation of Peristeen® was 20.21 (±5.56), n = 24. The mean score after two weeks of use was 12.75 (±4.40), n = 24. There was a statistically significant decrease of 7.46 (95%CI, 5.07-9.84) points, t(23) = 6.47, P < 0.0005 after two weeks. There was a statistically significant decrease in their scores from initiation to the 2 month time period of 7.00 (95%CI, 2.18-11.82) points, t(9) = 3.29, P = 0.009. By the sixth month of daily use the mean NBoDS score was 9.67 (n = 12). This was an average decrease of 8.83 (95%CI, 5.39-12.28) points from initiation score, t(11) = 5.641, P < 0.005.

CONCLUSION

The Peristeen® transanal irrigation system provides a significant reduction in NBoDS scores in pediatric patients with NBD. Peristeen® should be considered when other conservative bowel management options have been unsuccessful. Neurourol. Urodynam. 36:632-635, 2017. © 2016 Wiley Periodicals, Inc.

摘要

目的

使用针对儿科人群的经验证的神经源性肠道功能障碍评分系统,确定佩里斯汀经肛门冲洗系统减轻神经源性肠道功能障碍(NBD)患者症状的能力。

方法

3至21岁患有NBD且当前排便方案无效的患者,在开始使用佩里斯汀前、使用后2周、2个月和6个月时,分别填写神经源性肠道功能障碍(NBoDS)评分表。所有患者均开始使用佩里斯汀,每天用自来水(20毫升/千克)冲洗。完成均值和配对t检验。

结果

24例患者入组并接受随访。平均年龄为10.5岁(范围3至21岁),分别有25%、50%、25%的患者患有胸段、腰段和骶段水平的病变。开始使用佩里斯汀时的平均NBoDS评分为20.21(±5.56),n = 24。使用两周后的平均评分为12.75(±4.40),n = 24。两周后,得分在统计学上显著降低了7.46分(95%置信区间,5.07 - 9.84),t(23) = 6.47,P < 0.0005。从开始到2个月期间,他们的得分在统计学上显著降低了7.00分(95%置信区间,2.18 - 11.82),t(9) = 3.29,P = 0.009。到每日使用六个月时,平均NBoDS评分为9.67(n = 12)。这比初始得分平均降低了8.83分(95%置信区间,5.39 - 12.28),t(11) = 5.641,P < 0.005。

结论

佩里斯汀经肛门冲洗系统能显著降低患有NBD的儿科患者的NBoDS评分。当其他保守的肠道管理方案无效时,应考虑使用佩里斯汀。《神经泌尿学与尿动力学》36:632 - 635,2017年。©2016威利期刊公司

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