对脊膜脊髓膨出伴神经源性肠道功能紊乱的患儿以自来水灌肠的效果  

Tap-water enema for children with myelomeningocele and neurogenic bowel dysfunction

作　　者：Mattsson S. Gladh G. 李开(译) 

机构地区：[1]Department ofMolecular and Clinical Medicine, Division of Paediatrics,University Hospital, SE -58185LinkSping, Sweden] -ACTA PAEDIATR. INT. J. PAEDIATR. 2006, 95/3 (369-374) [2]不详

出　　处：《世界核心医学期刊文摘（儿科学分册）》2006年第8期19-19,共1页

摘　　要：Aim:To evaluate the outcome of transrectal irrigation(TRI)using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.Methods:40 children(21 boys and 19 girls;aged 10 mo to 11 y)with myelomeningocele and neurogenic bowel dysfunction were treated with TRI given by a stoma cone irrigation set daily or every second day.A questionnaire on the effects on faecal incontinence,constipation and self-management was completed by the parents,4 mo-8 y(median 1.5 y)after start.Effects on rectal volume,anal sphincter pressure and plasma sodium were evaluated before and after the start of irrigation.Results:At follow-up,35 children remained on TRI,four had received appendicostomy,while one defecated normally.For all children but five(35/40;85%)the procedure worked satisfactorily,but a majority found the procedur every time consuming and only one child was able to perform it independently.All children were free of constipation;most(35/40)were also anal continent.Rectal volume and anal sphincter pressure improved,while plasma sodium values remained within the normal range.Conclusion:Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction,but it does not help children to independence at the toilet.Aim： To evaluate the outcome of transrectal irrigation （TRI） using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems. Methods： 40 children （21 boys and 19 girls; aged 10 mo to 11 y） with myelomeningocele and neurogenic bowel dysfunction were treated with TRI given by a stoma cone irrigation set daily or every second day. A questionnaire on the effects on faecal incontinence, constipation and self-management was completed by the parents, 4 mo - 8 y （median 1.5 y） after start. Effects on rectal volume, anal sphincter pressure and plasma sodium were evaluated before and after the start of irrigation. Results： At follow-up, 35 children remained on TRI, four had received appendicostomy, while one defecated normally. For all children but five （35/40; 85% ） the procedure worked satisfactorily, but a majority found the procedur every time consuming and only one child was able to perform it independently. All children were free of constipation; most （35/ 40） were also anal continent. Rectal volume and anal sphincter pressure improved, while plasma sodium values remained within the normal range. Conclusion： Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction, but it does not help children to independence at the toilet.

关 键 词：肠道功能紊乱 脊膜脊髓膨出 神经源性 盐水灌肠 患儿 括约肌压力 肛门排便 直肠容量 中位年龄 大便失禁 

分 类 号：R574.4[医药卫生—消化系统] R651.2[医药卫生—内科学]