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大便失禁的治疗结果:45例患者的长期随访

Encopresis treatment outcome: long-term follow-up of 45 cases.

作者信息

Rockney R M, McQuade W H, Days A L, Linn H E, Alario A J

机构信息

Department of Pediatrics, Brown University School of Medicine, Rhode Island Hospital, Providence 02903, USA.

出版信息

J Dev Behav Pediatr. 1996 Dec;17(6):380-5. doi: 10.1097/00004703-199612000-00002.

Abstract

Among children diagnosed and treated for encopresis (N = 88) at either of two incontinence clinics between 1986 and 1994, 45 could be assessed for long-term (>12 months) outcome. Measures consisted of retrospective analysis of clinical charts and parent report of child soiling status. At follow-up (mean duration 53 months, range 15 to 99 months), 26 children (58%) were in remission, 13 (29%) were improved, and six (13%) showed no improvement. Logistic regression showed that children who presented with no previous encopresis treatment(s) (odds ratio 5.88, 95% confidence interval 1.61 to 21.55, p < .01) and/or children who presented with fecal retention (odds ratio 17.8, 95% confidence interval 2.70 to 153.37, p < .01) were more likely to be in remission. The interval between treatment and follow-up was significantly longer (mean 62 months, range 26 to 94) for children in remission than for children still soiling (mean 45 months, range 15 to 75) (p < .01). At follow-up 1 year or more after treatment for encopresis, a significant number of children may continue to soil. Previous encopresis treatment(s) and/or nonretentive encopresis may be risk factors for persistent soiling. The chances of complete remission of encopresis tend to increase with the passage of time.

摘要

1986年至1994年间,在两家大小便失禁诊所中,共有88名儿童被诊断为遗粪症并接受治疗,其中45名儿童可接受长期(>12个月)预后评估。评估方法包括对临床病历的回顾性分析以及家长对孩子弄脏情况的报告。随访时(平均时长53个月,范围15至99个月),26名儿童(58%)症状缓解,13名(29%)有所改善,6名(13%)无改善。逻辑回归分析显示,此前未接受过遗粪症治疗的儿童(优势比5.88,95%置信区间1.61至21.55,p < 0.01)和/或存在粪便潴留的儿童(优势比17.8,95%置信区间2.70至153.37,p < 0.01)更有可能症状缓解。症状缓解的儿童从治疗到随访的间隔时间显著更长(平均62个月,范围26至94个月),而仍有弄脏情况的儿童这一间隔时间平均为45个月(范围15至75个月)(p < 0.01)。在接受遗粪症治疗1年或更长时间后的随访中,仍有相当数量的儿童会继续弄脏。既往接受过遗粪症治疗和/或非潴留性遗粪症可能是持续弄脏的风险因素。遗粪症完全缓解的几率往往会随着时间的推移而增加。

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