Wei Y, Yang X D, Lan H B, Fan W B, Wang L N
Chengdu Anorectal Hospital, Chengdu, Sichuan 610015, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Dec 25;23(12):1220-1222. doi: 10.3760/cma.j.issn.441530-20200209-00043.
The was released in March 2018. This artide makes a joint interpretation of it with the (). The similarities and differences between the two mainly include: (1) The concept of constipation is basically the same, the main difference is that the consensus puts forward the association between constipation and mental disorders. (2) For constipation in terms of etiology, examination methods and evaluation, the consensus does not mention the etiology, but the examination methods are completely consistent. The reference standard of mental and psychological assessment is added in the consensus. (3) For the diagnosis of constipation, the diagnostic criteria and classification of constipation are specified in the guideline, and only the classification of constipation is mentioned briefly, while the consensus further develops the three different degrees of constipation. (4) For the treatment of constipation, the basic principles are the same. In the description of the specific treatment plan, the guideline divides the treatment methods of constipation into two categories: non-surgical treatment and surgical treatment, and then focuses on the suitability and specific operation of surgical treatment, while the consensus focuses more on coping strategies and treatment options for different degrees of constipation, including how to deal with the unavoidable mental and psychological disorders in the diagnosis and treatment of constipation questions. It can be seen that the consensus is a supplement and improvement of the guideline for surgical diagnosis and treatment of constipation. The consensus provides more targeted and applicable clinical reference ideas for clinical practice from different perspectives, especially the better auxiliary clinical decision-making after the quantification of the classification standard of constipation.
该文件于2018年3月发布。本文与()对其进行联合解读。两者的异同主要包括:(1)便秘的概念基本相同,主要区别在于共识提出了便秘与精神障碍之间的关联。(2)在便秘的病因、检查方法和评估方面,共识未提及病因,但检查方法完全一致。共识中增加了精神心理评估的参考标准。(3)对于便秘的诊断,指南中明确了便秘的诊断标准和分类,而共识中仅简要提及了便秘的分类,同时共识进一步细化了便秘的三个不同程度。(4)对于便秘的治疗,基本原则相同。在具体治疗方案的描述中,指南将便秘的治疗方法分为非手术治疗和手术治疗两类,然后重点阐述了手术治疗的适用性和具体操作,而共识则更侧重于不同程度便秘的应对策略和治疗选择,包括如何处理便秘诊治中不可避免的精神心理障碍问题。可以看出,共识是对便秘外科诊治指南的补充和完善。共识从不同角度为临床实践提供了更具针对性和适用性的临床参考思路,尤其是便秘分类标准量化后能更好地辅助临床决策。