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胫后神经刺激治疗大便失禁的疗效:一项系统评价

Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review.

作者信息

Ibáñez-Vera Alfonso Javier, Mondéjar-Ros Rosa María, Franco-Bernal Vanessa, Molina-Torres Guadalupe, Diaz-Mohedo Esther

机构信息

Department of Health Sciences, Campus las Lagunillas, University of Jaen, 23071 Jaen, Spain.

Physiotherapy Mondave, Avenida Juan Carlos I, 38, 30800 Lorca, Spain.

出版信息

J Clin Med. 2022 Sep 1;11(17):5191. doi: 10.3390/jcm11175191.

Abstract

Fecal incontinence is a condition that carries high social stigmatization and a determining factor in the quality of life of the person who suffers from it. Its etiology is multifactorial and treatment includes surgical and conservative measures, including stimulation of the posterior tibial nerve. The aim of this review is to determine whether posterior tibial nerve stimulation (PTNS) is more effective than other treatments in reducing episodes of fecal incontinence in adults. A systematic review of randomized clinical trials that analyzed different approaches and comparisons with other treatments in adults without neurological or metabolic diseases was carried out, analyzing, fundamentally, the reduction of episodes of fecal incontinence. In general, a reduction in fecal incontinence episodes is observed in the experimental groups compared with the control groups, although these differences are not significant in most studies. The results regarding the effectiveness of PTNS in reducing episodes of fecal incontinence compared to other treatments are not entirely conclusive, although benefits are observed regarding the stimulation of sacral roots. More well-designed studies with a long-term follow-up of the results are needed so that the recommendation of this treatment can be generalized.

摘要

大便失禁是一种背负着高度社会污名化的病症,也是困扰患者生活质量的一个决定性因素。其病因是多因素的,治疗方法包括手术和保守措施,其中就包括胫后神经刺激。这篇综述的目的是确定胫后神经刺激(PTNS)在减少成人粪便失禁发作方面是否比其他治疗方法更有效。我们对随机临床试验进行了系统综述,这些试验分析了不同的方法以及与无神经或代谢疾病的成人其他治疗方法的比较,主要分析了粪便失禁发作次数的减少情况。总体而言,与对照组相比,实验组的粪便失禁发作次数有所减少,不过在大多数研究中这些差异并不显著。与其他治疗方法相比,关于PTNS减少粪便失禁发作有效性的结果并不完全确凿,尽管在骶神经根刺激方面观察到了益处。需要进行更多设计良好且对结果进行长期随访的研究,以便能够推广这种治疗方法的推荐。

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