Minimally invasive electrical rectal stimulation promotes bowel emptying in an individual with spinal cord injury.
Minimally invasive electrical rectal stimulation promotes bowel emptying in an individual with spinal cord injury.
复制标题
微创直肠电刺激可促进脊髓损伤患者的肠道排空。
DOI：
10.1080/10790268.2023.2212335
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Bourbeau,Dennis
中科院分区：
文献类型：
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作者：
Colasante,Cesar;Brose,StevenW;Gustafson,Kenneth;Bourbeau,Dennis
SCI患者通常伴有神经源性肠功能障碍和结肠动力受损，这可能会严重影响健康和生活质量。肠道管理通常包括直肠指刺激（DRS），以调节直肠结肠反射，促进肠道排空。这个过程可能是耗时的，密集的，并导致直肠创伤。这项研究提出了一个描述使用电直肠刺激作为替代DRS，以帮助管理肠排空的人与SCI.MethodsWe进行了一项探索性的案例研究，一个65岁的男性与T4 AIS B SCI谁通常依赖于DRS作为他的定期肠道管理策略的主要组成部分。在6周期间随机选择的肠排空过程中，参与者通过直肠探头电极接受突发模式直肠电刺激（ERS）（50 mA，20脉冲/s，100 Hz），直到实现肠排空。 主要观察指标为完成肠常规所需的刺激周期数。在16个疗程中，仅在1个周期的ERS后就产生了排便。在13届会议上，完全实现了2个周期的ERS. ConclusionsERS与有效的肠排空。这项工作代表了第一次ERS已被用来影响肠排空的人与SCI。这种方法可以作为评估肠功能障碍的工具进行研究，并且可以进一步改进作为改善肠排空的工具。
ContextIndividuals with SCI typically live with neurogenic bowel dysfunction and impaired colonic motility that may significantly impact health and quality of life. Bowel management often includes digital rectal stimulation (DRS) to modulate the recto-colic reflex to promote bowel emptying. This procedure can be time-consuming, caregiver-intensive, and lead to rectal trauma. This study presents a description of using electrical rectal stimulation as an alternative to DRS to help manage bowel emptying in a person with SCI.MethodsWe conducted an exploratory case study with a 65-year-old male with a T4 AIS B SCI who normally relies on DRS as the main component of his regular bowel management strategy. In randomly selected bowel emptying sessions during a 6-week period, the participant received burst-pattern electrical rectal stimulation (ERS) (50 mA, 20 pulses/s at 100 Hz), via a rectal probe electrode until bowel emptying was achieved. The primary outcome measure was number of cycles of stimulation required to complete the bowel routine.Results17 sessions were performed using ERS. In 16 sessions, a bowel movement was produced after only 1 cycle of ERS. In 13 sessions, complete bowel emptying was achieved with 2 cycles of ERS.ConclusionsERS was associated with effective bowel emptying. This work represents the first time ERS has been used to affect bowel emptying in someone with SCI. This approach could be investigated as a tool to evaluate bowel dysfunction, and it could be further refined as a tool for improving bowel emptying.