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胫后神经刺激治疗大便失禁:一项系统评价与Meta分析

Posterior Tibial Nerve Stimulation in Fecal Incontinence: A Systematic Review and Meta-Analysis.

作者信息

Sarveazad Arash, Babahajian Asrin, Amini Naser, Shamseddin Jebreil, Yousefifard Mahmoud

机构信息

Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.

Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.

出版信息

Basic Clin Neurosci. 2019 Sep-Oct;10(5):419-431. doi: 10.32598/bcn.9.10.290. Epub 2019 Sep 1.

Abstract

INTRODUCTION

The present systematic review and meta-analysis aims to investigate the role of Posterior Tibial Nerve Stimulation (PTNS) in the control of Fecal Incontinence (FI).

METHODS

Two independent reviewers extensively searched in the electronic databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, CINAHL, and Scopus for the studies published until the end of 2016. Only randomized clinical trials were included. The studied outcomes included FI episodes, FI score, resting pressure, squeezing pressure, and maximum tolerable pressure. The data were reported as Standardized Mean Differences (SMD) with 95% confidence interval.

RESULTS

Five articles were included in the present study (249 patients under treatment with PTNS and 239 in the sham group). Analyses showed that PTNS led to a significant decrease in the number of FI episodes (SMD=-0.38; 95% CI: -0.67-0.10; P=0.009). Yet, it did not have an effect on FI score (SMD=0.13; 95% CI: -0.49-0.75; P=0.68), resting pressure (SMD=0.12; 95% CI: -0.14-0.37; P=0.67), squeezing pressure (SMD=-0.27; 95% CI: -1.03-0.50; P=0.50), and maximum tolerable pressure (SMD=-0.10; 95% CI: -0.40-0.24; P=0.52).

CONCLUSION

Based on the results, it seems that the prescription of PTNS alone cannot significantly improve FI.

摘要

引言

本系统评价和荟萃分析旨在研究胫后神经刺激(PTNS)在控制大便失禁(FI)中的作用。

方法

两名独立评审员在Medline、Embase、Cochrane对照试验中央注册库(CENTRAL)、科学网、CINAHL和Scopus等电子数据库中广泛检索截至2016年底发表的研究。仅纳入随机临床试验。研究的结局包括大便失禁发作次数、大便失禁评分、静息压力、挤压压力和最大耐受压力。数据以标准化均数差(SMD)及95%置信区间报告。

结果

本研究纳入了5篇文章(249例接受PTNS治疗的患者和239例假手术组患者)。分析表明,PTNS导致大便失禁发作次数显著减少(SMD=-0.38;95%CI:-0.67-0.10;P=0.009)。然而,它对大便失禁评分(SMD=0.13;95%CI:-0.49-0.75;P=0.68)、静息压力(SMD=0.12;95%CI:-0.14-0.37;P=0.67)、挤压压力(SMD=-0.27;95%CI:-1.03-0.50;P=0.50)和最大耐受压力(SMD=-0.10;95%CI:-0.40-0.24;P=0.52)均无影响。

结论

基于这些结果,似乎单独使用PTNS处方不能显著改善大便失禁。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d9c/7149953/6b9ee8652630/BCN-10-419-g001.jpg

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