Kelly Maryellen S
Division of Urology, Department of Surgery, Duke University Medical Center, Box 3831, Durham, NC, 27710, USA.
Curr Urol Rep. 2019 Jun 10;20(8):41. doi: 10.1007/s11934-019-0909-1.
No gold standard exists for managing neurogenic bowel dysfunction, specifically in individuals with spina bifida. Since the International Children's Continence Society published its consensus document on neurogenic bowel treatment in 2012, an increased focus on why we must manage bowels and how to improve our management has occurred. This review provides updated information for clinicians.
A surge in research, mostly retrospective, has been conducted on the success and satisfaction of three types of management for neurogenic bowel. All three management techniques have relatively high success rates for fecal continence and satisfaction rates. Selection of which treatment to carry out still is debated among clinicians. Transanal irrigation is a safe and effective management option for neurogenic bowel that does not require surgery. Antegrade enemas can be carried out via cecostomy tube or Malone antegrade continence enema with similar fecal continence outcomes.
对于神经源性肠道功能障碍的管理，目前尚无金标准，尤其是对于脊柱裂患者。自国际儿童尿失禁协会于2012年发布关于神经源性肠道治疗的共识文件以来，人们越来越关注为何必须管理肠道以及如何改进我们的管理方法。本综述为临床医生提供了最新信息。
针对神经源性肠道的三种管理方式的成功率和满意度，开展了大量研究，其中大多为回顾性研究。所有这三种管理技术在粪便失禁方面的成功率和满意度都相对较高。临床医生对于选择哪种治疗方法仍存在争议。经肛门灌洗是一种安全有效的神经源性肠道管理选择，无需手术。顺行灌肠可通过盲肠造瘘管或马龙顺行可控灌肠进行，粪便失禁结果相似。
