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放射监督下的肠道管理方案对慢性特发性便秘患者的疗效。

Radiologically supervised bowel management program outcome in patients with chronic idiopathic constipation.

机构信息

Department of Surgery, Division of Pediatric Surgery, International Center for Colorectal and Urogenital Care at Children's Hospital Colorado, Universtity of Colorado, 13213 E 16th Ave, Anschutz Medical Campus, Box 323, Aurora, CO, 80045, USA.

出版信息

Pediatr Surg Int. 2023 Jul 10;39(1):229. doi: 10.1007/s00383-023-05508-9.

Abstract

PURPOSE

This study aimed to analyze our radiologically supervised bowel management program (RS-BMP) outcomes in patients with chronic idiopathic constipation (CIC).

METHODS

A retrospective study was conducted. We included all patients with CIC who participated in our RS-BMP at Children´s Hospital Colorado from July 2016 to October 2022.

RESULTS

Eighty patients were included. The average time with constipation was 5.6 years. Before our RS-BMP, 95% had received non-radiologically supervised treatments, and 71% had attempted two or more treatments. Overall, 90% had tried Polyethylene Glycol and 43% Senna. Nine patients had a history of Botox injections. Five underwent anterograde continence procedure, and one a sigmoidectomy. Behavioral disorders (BD) were found in 23%. At the end of the RS-BMP, 96% of patients had successful outcomes, 73% were on Senna, and 27% were on enemas. Megarectum was detected in 93% of patients with successful outcomes and 100% with unsuccessful outcomes (p = 0.210). Of the patients with BD, 89% had successful outcomes, and 11% had unsuccessful.

CONCLUSION

Our RS-BMP has been proven to be effective in treating CIC. The radiologically supervised use of Senna and enemas was the appropriate treatment in 96% of the patients. BD and megarectum were associated with unsuccessful outcomes.

摘要

目的

本研究旨在分析我们在慢性特发性便秘(CIC)患者中实施的放射监督肠道管理计划(RS-BMP)的结果。

方法

进行了一项回顾性研究。我们纳入了 2016 年 7 月至 2022 年 10 月期间在科罗拉多儿童医院参加我们的 RS-BMP 的所有 CIC 患者。

结果

共纳入 80 例患者。便秘的平均时间为 5.6 年。在我们的 RS-BMP 之前,95%的患者接受了非放射监督治疗,71%的患者尝试了两种或更多种治疗。总体而言,90%的患者尝试了聚乙二醇,43%的患者尝试了番泻叶。9 例患者有肉毒杆菌毒素注射史。5 例行顺行性节制手术,1 例行乙状结肠切除术。23%的患者存在行为障碍(BD)。RS-BMP 结束时,96%的患者取得了成功的结果,73%的患者使用番泻叶,27%的患者使用灌肠。成功结果的患者中 93%存在巨直肠,而不成功结果的患者中 100%存在巨直肠(p=0.210)。BD 的患者中,89%取得了成功的结果,11%的患者失败。

结论

我们的 RS-BMP 已被证明对治疗 CIC 有效。96%的患者在放射监督下使用番泻叶和灌肠是适当的治疗方法。BD 和巨直肠与不成功的结果相关。

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