Geders J M, Gaing A, Bauman W A, Korsten M A
Section of Gastroenterology, Bronx VA Medical Center, New York, New York.
Am J Gastroenterol. 1995 Feb;90(2):285-9.
The pathophysiological consequences of spinal cord injury (SCI) on function of the colon are complex and poorly understood. Regardless of the mechanism, many patients with SCI have deficient bowel control, which is frustrating and difficult to treat. We designed a study to assess whether a new prokinetic medication, cisapride, might be useful in this setting.
Total and segmental colonic transit time were measured using the radiopaque marker technique in nine subjects with spinal cord injury and seven control subjects after the double-blind administration of cisapride (10 mg q.i.d.) or placebo.
In five quadriplegic subjects with prolonged colonic transit time, administration of cisapride was found to reduce left-sided colonic transit time from 24.2 to 13.8 h. In three of these five subjects, cisapride administration resulted in subjective improvement. No effect of cisapride on right-sided, rectosigmoid, or total colonic transit time was observed.
The data suggest that cisapride might be a useful adjunctive measure in treating a subset of SCI patients with colonic inertia, but a larger study is needed before this can be routinely recommended.
脊髓损伤（SCI）对结肠功能的病理生理影响复杂且了解不足。无论机制如何，许多SCI患者存在排便控制缺陷，这令人沮丧且难以治疗。我们设计了一项研究，以评估一种新的促动力药物西沙必利在此情况下是否有用。
在9名脊髓损伤患者和7名对照受试者中，采用不透X线标记技术，在双盲给予西沙必利（10毫克，每日4次）或安慰剂后，测量全结肠和节段性结肠转运时间。
在5名结肠转运时间延长的四肢瘫痪患者中，发现给予西沙必利可使左侧结肠转运时间从24.2小时缩短至13.8小时。在这5名患者中的3名中，给予西沙必利后主观症状有改善。未观察到西沙必利对右侧、直肠乙状结肠或全结肠转运时间有影响。
数据表明，西沙必利可能是治疗一部分患有结肠惰性的SCI患者的有用辅助措施，但在能够常规推荐之前，还需要进行更大规模的研究。
