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脊髓损伤患者神经源性肠道功能障碍严重程度与功能状态、抑郁和生活质量的关系。

Relationship between neurogenic bowel dysfunction severity and functional status, depression, and quality of life in individuals with spinal cord injury.

机构信息

Department of Physical Medicine and Rehabilitation, Bursa Uludag University School of Medicine, Bursa, Turkey.

Department of Biostatistics, Bursa Uludag University School of Medicine, Bursa, Turkey.

出版信息

J Spinal Cord Med. 2023 May;46(3):424-432. doi: 10.1080/10790268.2021.2021043. Epub 2022 Feb 2.

Abstract

To evaluate the relationship between severity of neurogenic bowel dysfunction (NBD) and functional status, depression, and quality of life in individuals with spinal cord injury (SCI) and to determine the factors associated with developing moderate-to-severe NBD. Cross-sectional study. University hospital rehabilitation outpatient clinic. Individuals with traumatic SCI, at least one year post-injury (N = 92). Not applicable. Neurogenic Bowel Dysfunction Score, Functional Independence Measure (FIM), Beck Depression Inventory (BDI), and Short Form-36 (SF-36). In the current sample, we found that half of the individuals with SCI had moderate-to-severe NBD. Individuals with moderate and severe NBD had lower motor FIM ( = 0.008 and  = 0.006, respectively) and SF-36 physical functioning (PF) scale ( = 0.020 and  = 0.031, respectively) scores than individuals with very minor NBD. There was no difference in the BDI scores among individuals with different levels of NBD. Individuals with American Spinal Injury Association Impairment Scale (AIS) A injuries were more likely to develop moderate-to-severe NBD than those with AIS C (odds ratio (OR) = 6.52; 95% confidence interval (CI) 1.13-37.79;  = 0.005) or AIS D (OR = 17.19; 95% CI 3.61-81.82;  < 0.001) injuries. Individuals with moderate-to-severe NBD had higher levels of dependency in activities of daily living and lower SF-36 PF scale scores than individuals with very minor NBD. Among individuals with SCI, completeness of injury was a significant factor for developing moderate-to-severe NBD.

摘要

为了评估神经源性肠道功能障碍(NBD)的严重程度与脊髓损伤(SCI)患者的功能状态、抑郁和生活质量之间的关系,并确定与中重度 NBD 相关的因素。这是一项横断面研究,研究地点为大学医院康复门诊,参与者为至少受伤 1 年的外伤性 SCI 患者(N=92)。神经源性肠道功能障碍评分、功能独立性测量(FIM)、贝克抑郁量表(BDI)和简明健康调查问卷 36 项(SF-36)。在当前样本中,我们发现有一半的 SCI 患者存在中重度 NBD。中重度 NBD 患者的运动 FIM( = 0.008 和  = 0.006)和 SF-36 生理功能(PF)量表评分( = 0.020 和  = 0.031)均低于轻度 NBD 患者。不同 NBD 严重程度患者的 BDI 评分无差异。美国脊髓损伤协会损伤分级(AIS)为 A 级的患者比 AIS 为 C 级(比值比(OR)=6.52;95%置信区间(CI)为 1.13-37.79;  = 0.005)或 AIS 为 D 级(OR=17.19;95%CI 为 3.61-81.82;  < 0.001)的患者更容易发展为中重度 NBD。中重度 NBD 患者的日常生活活动依赖程度更高,SF-36 PF 量表评分更低。在 SCI 患者中,损伤的完整性是发展为中重度 NBD 的重要因素。

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