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经肛门冲洗治疗儿童顽固性功能性便秘

Transanal Irrigation in the Treatment of Children With Intractable Functional Constipation.

作者信息

Koppen Ilan J N, Kuizenga-Wessel Sophie, Voogt Heleen W, Voskeuil Marijke E, Benninga Marc A

机构信息

*Department of Pediatric Gastroenterology and Nutrition †Department of Pediatric Surgery, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.

出版信息

J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):225-229. doi: 10.1097/MPG.0000000000001236.

Abstract

OBJECTIVES

The aim of the study was to assess the treatment efficacy of transanal irrigation and parental satisfaction in children with intractable functional constipation (FC) treated with Peristeen.

METHODS

Cross-sectional survey study among parents of children (age 0-18 years) treated with Peristeen for FC (based on the Rome III criteria). Anonymous questionnaires were sent out to parents via mail, these consisted of 25 self-developed, multiple-choice questions regarding the use of Peristeen, current gastrointestinal symptoms, adverse effects of Peristeen, concomitant medication use, and parental satisfaction.

RESULTS

Out of 91 invited families, 67 (74%) returned the questionnaire. In total, 84% of patients experienced fecal incontinence prior to treatment. Out of all children who still used Peristeen at the time of survey (n = 49), fecal incontinence had resolved completely in 41%, 12% experienced occasional episodes of fecal incontinence (<1 episode per week) and the remaining 47% still experienced episodes of fecal incontinence regularly (≥1 time per week). A total of 28 children (42%) experienced pain during rectal irrigation, especially during insertion of the catheter, inflating the balloon, or during irrigation. Overall, 86% of the parents were satisfied with the result of transanal irrigation and 67% reported that they would continue using transanal irrigation for the treatment of their child's symptoms.

CONCLUSIONS

Transanal irrigation may be effective in the treatment of children with FC and renders a high parental satisfaction. Future prospective studies, preferably RCTs, are necessary to further evaluate this treatment option.

摘要

目的

本研究旨在评估经肛门灌洗对难治性功能性便秘(FC)患儿的治疗效果以及家长满意度,这些患儿采用佩里斯汀(Peristeen)进行治疗。

方法

对符合罗马III标准、采用佩里斯汀治疗FC的0至18岁患儿家长进行横断面调查研究。通过邮件向家长发放匿名问卷,问卷包含25个自行设计的多项选择题,内容涉及佩里斯汀的使用情况、当前胃肠道症状、佩里斯汀的不良反应、伴随用药情况以及家长满意度。

结果

在91个受邀家庭中,67个(74%)回复了问卷。总体而言,84%的患者在治疗前存在大便失禁情况。在调查时仍在使用佩里斯汀的所有患儿(n = 49)中,41%的患儿大便失禁已完全缓解,12%的患儿偶尔出现大便失禁情况(每周<1次),其余47%的患儿仍经常出现大便失禁情况(每周≥1次)。共有28名患儿(42%)在直肠灌洗过程中感到疼痛,尤其是在插入导管、充盈气囊或灌洗过程中。总体而言,86%的家长对经肛门灌洗的效果感到满意,67%的家长表示他们会继续使用经肛门灌洗来治疗孩子的症状。

结论

经肛门灌洗可能对FC患儿有效,并使家长满意度较高。未来有必要进行前瞻性研究,最好是随机对照试验,以进一步评估这种治疗选择。

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