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经骶神经调节治疗粪便失禁后自我报告抑郁的改善。

Improvements in Self-Reported Depression Following Treatment of Fecal Incontinence with Sacral Neuromodulation.

机构信息

Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.

School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.

出版信息

Neuromodulation. 2020 Dec;23(8):1158-1163. doi: 10.1111/ner.13249. Epub 2020 Aug 17.

Abstract

OBJECTIVE

To evaluate changes in self-reported depression after treatment of fecal incontinence (FI) with sacral neuromodulation.

MATERIALS AND METHODS

This is a subanalysis of data collected from March 2016 to October 2017 for an Institutional Review Board-approved retrospective cohort study. Demographic information, medical history, psychiatric comorbidities, and the Patient-Reported Outcomes Measurement Information System item bank t-scores were extracted from the electronic medical record. The differences in t-scores were compared with a two-sided paired t-test, and a p value <0.05 was considered statistically significant.

RESULTS

Of the cohort (n = 24), most were Caucasian (88%), female (92%), nonsmokers (92%). Median age was 63.5 years (interquartile range 57.5-71.0 years) and median body mass index was 27.7 kg/m (range 18.3-42.9 kg/m ). A significant decrease in mean depression t-scores occurred after implantation of a sacral neuromodulation device, -4.5 (95% confidence interval [CI]: -8.7, -0.2, p = 0.04). Self-reported pain interference (p = 0.37) and physical function (p = 0.47) scores were similar following implantation. Individuals with comorbid anxiety reported the greatest improvement in depression (-6.5, 95% CI: -11.8, -1.1, p = 0.02).

CONCLUSIONS

Treatment of FI with sacral neuromodulation was associated with improvement in self-reported depression with the greatest improvement in those with anxiety. Further prospective research is needed to corroborate these findings.

摘要

目的

评估骶神经调节治疗粪便失禁(FI)后患者抑郁自评的变化。

材料与方法

这是一项从 2016 年 3 月至 2017 年 10 月收集的数据的回顾性队列研究的亚分析。从电子病历中提取人口统计学信息、病史、精神共病和患者报告的结局测量信息系统(PROMIS)项目库 t 评分。使用双侧配对 t 检验比较 t 评分的差异,p 值<0.05 被认为具有统计学意义。

结果

在队列中(n=24),大多数为白人(88%)、女性(92%)、不吸烟者(92%)。中位年龄为 63.5 岁(四分位间距 57.5-71.0 岁),中位体质指数为 27.7kg/m(范围 18.3-42.9kg/m)。植入骶神经调节装置后,抑郁 t 评分的均值显著下降,为-4.5(95%置信区间[CI]:-8.7,-0.2,p=0.04)。植入后,自我报告的疼痛干扰(p=0.37)和身体功能(p=0.47)评分相似。伴有焦虑共病的个体报告抑郁改善最大(-6.5,95%CI:-11.8,-1.1,p=0.02)。

结论

骶神经调节治疗 FI 与抑郁自评的改善相关,伴有焦虑的患者改善最大。需要进一步的前瞻性研究来证实这些发现。

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