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经肛门肠道冲洗在神经源性肠功能障碍患者中的应用:一项综合文献回顾。

Transanal Irrigation for People With Neurogenic Bowel Dysfunction: An Integrative Literature Review.

机构信息

Erika Boman, PhD, RNT, is Lecturer, Department of Nursing, Umeå University, Umeå, Sweden; Department of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.

Malin Nylander, BSc, RN, is a former RN student at Umeå University, Umeå, Sweden.

出版信息

Gastroenterol Nurs. 2022;45(4):211-230. doi: 10.1097/SGA.0000000000000645. Epub 2022 Jul 13.

Abstract

Transanal irrigation has been introduced as a complement to standard bowel care for people with neurogenic bowel dysfunction. There is no contemporary integrative review of the effectiveness and feasibility of transanal irrigation from a holistic nursing perspective, only fragments of evidence to date. The aim was to investigate the effectiveness and feasibility of transanal irrigation for people with neurogenic bowel dysfunction. An integrative literature review was conducted. Nineteen studies were included. According to the results, transanal irrigation can reduce difficulties associated with defecation, episodes of incontinence, and the time needed for evacuation and bowel care. Transanal irrigation can increase general satisfaction with bowel habits and quality of life and decrease level of dependency. However, there are practical problems to overcome and adverse effects to manage. Discontinuation is relatively common. The results support the effectiveness of transanal irrigation, but feasibility is inconclusive. Users, including caregivers, report practical problems, and compliance was not always easy to achieve. It is important that users, including caregivers, are well informed and supported during transanal irrigation treatment, especially during introduction. The quality of the studies found was generally weak; therefore, high-quality quantitative and qualitative studies are needed on the topic.

摘要

经肛门肠道冲洗已被引入作为对神经源性肠道功能障碍患者的标准肠道护理的补充。从整体护理的角度来看,目前还没有对经肛门肠道冲洗的有效性和可行性进行综合评价的研究,只有一些零散的证据。本研究旨在调查经肛门肠道冲洗对神经源性肠道功能障碍患者的有效性和可行性。进行了综合文献回顾。共纳入了 19 项研究。结果表明,经肛门肠道冲洗可以减少与排便相关的困难、失禁发作以及排空和肠道护理所需的时间。经肛门肠道冲洗可以增加对肠道习惯和生活质量的总体满意度,并降低依赖性水平。但是,存在需要克服的实际问题和需要管理的不良反应。停止治疗相对常见。结果支持经肛门肠道冲洗的有效性,但可行性尚无定论。使用者,包括护理人员,报告存在实际问题,并且并非总是容易做到坚持治疗。在经肛门肠道冲洗治疗期间,特别是在引入期间,让使用者(包括护理人员)充分知情并得到支持非常重要。所发现的研究质量普遍较差;因此,需要对该主题进行高质量的定量和定性研究。

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