Tolia V, Lin C H, Elitsur Y
Division of Pediatric Gastroenterology and Nutrition, Children's Hospital of Michigan, Wayne State University, Detroit.
Aliment Pharmacol Ther. 1993 Oct;7(5):523-9. doi: 10.1111/j.1365-2036.1993.tb00128.x.
Faecal impaction with or without encopresis is a very common problem. We performed a randomized, open-label, prospective study to compare the efficacy and acceptability of the treatment of faecal impaction using either mineral oil or pineapple-flavoured isotonic intestinal lavage solution containing polyethylene glycol-3350 (Colyte). Thirty-six patients over 2 years of age were randomized to receive either mineral oil or flavoured lavage solution. The dose of mineral oil was 2 to 8 tablespoons twice a day for two days (17 patients--Group I) and of lavage solution was 20 ml/kg/h for 4 hours on two consecutive days (19 patients--Group II). The patients were assessed for the presence of abdominal faecal masses, presence and consistency of rectal mass, perineal soiling before and two days after either of the randomly assigned treatment. The patients and parents were asked regarding the compliance with treatment, side-effects, number of bowel movements after treatment and willingness to try similar treatment if faecal impaction recurred. Patients in the lavage group had more frequent bowel movements, and showed more effective clearance of abdominal and rectal lumps (P < 0.01) at the time of repeat examination at two days. However, they had some vomiting and were less compliant (P < 0.01) when compared to mineral oil patients. We conclude that balanced lavage solution effectively relieves faecal impaction, however, compliance with its use is poorer than that with mineral oil.
伴有或不伴有大便失禁的粪便嵌塞是一个非常常见的问题。我们进行了一项随机、开放标签的前瞻性研究，以比较使用矿物油或含聚乙二醇-3350的菠萝味等渗肠道灌洗溶液（Colyte）治疗粪便嵌塞的疗效和可接受性。36名2岁以上的患者被随机分为接受矿物油或调味灌洗溶液两组。矿物油的剂量为每天两次，每次2至8汤匙，共两天（17名患者——第一组）；灌洗溶液的剂量为连续两天，以20 ml/kg/h的速度输注4小时（19名患者——第二组）。在随机分配的任何一种治疗前和治疗后两天，对患者进行腹部粪块、直肠肿块的存在及质地、会阴部污染情况的评估。询问患者及其父母关于治疗的依从性、副作用、治疗后排便次数以及如果粪便嵌塞复发是否愿意尝试类似治疗。灌洗组患者排便更频繁，在两天后的复查时，腹部和直肠肿块的清除效果更显著（P < 0.01）。然而，与矿物油组患者相比，他们出现了一些呕吐，依从性较差（P < 0.01）。我们得出结论，平衡灌洗溶液能有效缓解粪便嵌塞，然而，其使用的依从性比矿物油差。
