大便失禁病理生理研究基础及诊疗策略更新现状  

Progress in pathophysiology research and update on diagnosis and treatment strategies for fecal incontinence

作　　者：陆立 Lu Li(Department of General Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院普通外科(肛肠外科)、广东省结直肠盆底疾病研究重点实验室、广州市黄埔区中六生物医学创新研究院,广州510655

出　　处：《中华胃肠外科杂志》2023年第12期1126-1131,共6页Chinese Journal of Gastrointestinal Surgery

基　　金：广东省消化系统疾病临床医学研究中心项目(2020B1111170004);国家临床重点专科。

摘　　要：传统屏障理论认为,大便失禁与直肠肛管屏障作用失衡及大便性状相关。但在临床实践中,其被证实并不能准确解释所有类型的大便失禁。近年来,大便失禁相关机制研究已转变为从整体入手,将直肠肛门作为功能单元、通过中枢-外周神经系统支配及肛门内外括约肌调控的环路机制的新理念;以骶神经调控术为主流术式的大便失禁诊疗策略正悄然发生变化。随着中国人口老龄化程度加深,提升大便失禁诊疗需求越来越急迫,本文从大便失禁病理生理研究进展及诊疗方式更新角度,探讨其诊疗及机制研究趋势。The traditional barrier theory believes that fecal incontinence is related to an imbalance of the recto-anal barrier and the characteristics of stool.However,in clinical practice this theory proves unable to explain all types of fecal incontinence.In recent years,research on the mechanisms related to fecal incontinence has shifted to a new integrative concept with the rectum and anus as functional units,and the central-peripheral nervous system and internal and external anal sphincters as a control loop.The diagnosis and treatment strategy of fecal incontinence,which is replaced by sacral neuromodulation,is undergoing a quiet change.With the progressively aging population in China,the need to improve the diagnosis and treatment of fecal incontinence has become increasingly urgent.This article explores the trends in diagnosis and treatment and mechanism research from the perspective of recent advances in pathophysiological research and updated diagnosis and treatment methods for fecal incontinence.

关 键 词：大便失禁 病因学 屏障理论 整体理论 骶神经调节术 

分 类 号：R574.6[医药卫生—消化系统]