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肛门直肠畸形手术患者粪便失禁及生活质量的长期评估

Long-term evaluation of fecal continence and quality of life in patients operated for anorectal malformations.

作者信息

Tannuri Ana Cristina Aoun, Ferreira Mariana Aparecida Elisei, Mathias Arthur Loguetti, Tannuri Uenis

机构信息

Associate Professor, Faculdade de Medicina, Universidade de São Paulo (FMUSP). Physician, Service of Pediatric Surgery and Liver Transplantation, Instituto da Criança, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil.

Medical Student, FMUSP, São Paulo, SP, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2016 Sep;62(6):544-552. doi: 10.1590/1806-9282.62.06.544.

Abstract

INTRODUCTION

: Patients operated for correction of anorectal malformations (ARM) can develop fecal incontinence, constipation, and soiling, with loss in quality of life.

OBJECTIVE

: To evaluate, through the use of questionnaires, fecal continence, and quality of life of children in the late postoperative follow-up of ARM correction, both high and low. In addition, the levels of fecal continence and quality of life were compared with those of a control group.

METHOD

: A Fecal Continence Index Questionnaire (ICF) and a Questionnaire for Assessment of Quality of Life Related to Fecal Continence in Children and Adolescents (QQVCFCA) were administered to 63 patients with ARM, aged from 7 to 19 years, whose surgical treatment had been completed for at least 6 months. The patients were compared to a control group of 59 children.

RESULTS

: In the control group, 25 (42.4%) patients had good continence and 34 (57.6%), normal continence. We found that the quality of life in children with ARM is compromised globally, in all areas and in the ICF questionnaire, compared to controls (p<0.001). There was no difference between patients with high and low defects. Thirty-two (50.8%) patients had other associated anomalies.

CONCLUSION

: In patients operated for ARM correction, quality of life and ICF were compromised, and there was no difference between patients with high-type and low-type of the disease. In about half the cases there are other associated malformations.

摘要

引言

接受肛门直肠畸形(ARM)矫正手术的患者可能会出现大便失禁、便秘和便污问题,生活质量下降。

目的

通过问卷调查评估接受高、低位ARM矫正术后儿童的大便失禁情况和生活质量。此外,将大便失禁水平和生活质量与对照组进行比较。

方法

对63例年龄在7至19岁、手术治疗已完成至少6个月的ARM患者进行了大便失禁指数问卷(ICF)和儿童及青少年大便失禁相关生活质量评估问卷(QQVCFCA)调查。将这些患者与59名儿童组成的对照组进行比较。

结果

在对照组中,25例(42.4%)患者大便控制良好,34例(57.6%)患者大便控制正常。我们发现,与对照组相比,ARM患儿的生活质量在全球范围内、所有领域以及ICF问卷中均受到损害(p<0.001)。高位和低位缺陷患者之间没有差异。32例(50.8%)患者有其他相关异常。

结论

接受ARM矫正手术的患者,生活质量和ICF均受到损害,疾病的高位型和低位型患者之间没有差异。约一半病例存在其他相关畸形。

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