肠道管理系统对小儿排粪失禁的治疗作用  

Role of bowel management program in pediatric patients with fecal incontinence

作　　者：王勇[1] 余家康 钟军 钟微 刘涛 关茜思 

机构地区：[1]广州市妇女儿童医疗中心小儿外科,510623

出　　处：《中华胃肠外科杂志》2014年第7期672-675,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的 评价肠道管理系统治疗小儿排粪失禁的疗效.方法 回顾性分析2012年1月至2013年1月间,广州市妇女儿童医疗中心小儿外科通过肠道管理系统（即利用粪便可在结肠内停留24～48 h的原理,采用灌肠方法,一次性清除结肠内的所有粪便,从而保持患儿肛周24 h清洁,改善临床症状）治疗19例排粪失禁患儿的临床资料.结果 19例患儿中,15例真性排粪失禁,4例假性排粪失禁.经肠道管理系统治疗后,真性排粪失禁患儿,粪污及便秘情况改善;假性失禁患儿中2例可通过口服药物自主控制排粪,另2例失禁症状完全缓解.结论 肠道管理系统可有效治疗小儿排粪失禁,其成功的关键在于反复调整灌肠液,找到最佳配比和用量,并保证患儿24 h肛周洁净.Objective To investigate a new bowel management program for children patients with fecal incontinence.Methods Clinical data of 19 children with fecal incontinence undergoing bowel management program in our center between January 2012 and January 2013 were retrospectively analyzed.The main outcome measure was clinical efficacy of this program.Results Fifteen out of 19 cases were genuine fecal incontinence and required continuous treatment by enema.The other 4 cases were false fecal incontinence.After treatment with this program,stool dirty and constipation were improved in genuine incontinence.Two cases of false continence could control defecation independently by oral administration of antispasmodic drug.Two cases of false continence were cured and did not need medical interference.Conclusions Bowel management program is an effective treatment for pediatric patients with fecal incontinence.The key of success is maintenance of perianal hygiene for 24 hours by continual adjustment of the elements and volumes of enemas.

关 键 词：小儿 排粪失禁 肠道管理系统 灌肠 

分 类 号：R726.5[医药卫生—儿科]