Robertson Janet, Baines Susannah, Emerson Eric, Hatton Chris
Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
Centre for Disability Research and Policy, University of Sydney, Sydney, NSW, Australia.
J Appl Res Intellect Disabil. 2018 Sep;31(5):709-724. doi: 10.1111/jar.12426. Epub 2017 Nov 23.
Constipation can lead to serious health issues and death. This systematic review summarizes international research pertaining to the management of constipation in people with intellectual disability.
Studies published from 1990 to 2017 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests and cross-citations. Studies were reviewed narratively in relation to identified themes.
Eighteen studies were reviewed in relation to three themes: laxative receipt; interventions (dietary fibre, abdominal massage and macrogol); and staff issues (knowledge and training). Laxative polypharmacy was common. Studies report positive results for dietary fibre and abdominal massage although study quality was limited.
The main management response to constipation in people with intellectual disability is laxative use despite limited effectiveness. An improved evidence base is required to support the suggestion that an individualized, integrated bowel management programme may reduce constipation and associated health conditions in people with intellectual disability.
便秘可导致严重的健康问题甚至死亡。本系统评价总结了有关智力残疾者便秘管理的国际研究。
使用Medline、Cinahl、PsycINFO、科学网、电子邮件请求和交叉引用等方式，检索1990年至2017年发表的研究。根据确定的主题对研究进行叙述性综述。
针对三个主题对18项研究进行了综述：泻药使用情况；干预措施（膳食纤维、腹部按摩和聚乙二醇）；以及工作人员问题（知识和培训）。泻药联合使用很常见。尽管研究质量有限，但研究报告了膳食纤维和腹部按摩的积极效果。
尽管效果有限，但智力残疾者便秘的主要管理应对措施仍是使用泻药。需要改进证据基础，以支持个体化、综合肠道管理方案可能减少智力残疾者便秘及相关健康问题这一建议。
