Transanal irrigation improves quality of life in patients with low anterior resection syndrome
Transanal irrigation improves quality of life in patients with low anterior resection syndrome
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DOI：
10.1111/j.1463-1318.2011.02692.x
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发表时间：
2011-10-01
影响因子：
3.4
通讯作者：
Roche, B.
中科院分区：
文献类型：
--
作者：
Rosen, H.;Robert-Yap, J.;Roche, B.
目的经肛门冲洗(TAI)是治疗“前切除术综合征”(ARS)的一种廉价而有效的方法。本研究旨在评价其对ARS患者生活质量(QOL)的影响。方法在两个结直肠中心的前瞻性研究中，14例患者(11名男性，中位年龄68岁(45-80岁))纳入研究。ARS的中位病程为19个月(9-48个月)。平均日排便次数为8(4-12)次/日，排便次数为3(2-5)次/夜。在造口护士的指导下，所有患者都接受了使用Peristeen(TM)系统进行TAI的培训。进行肛门生理检查，用SF-36和Rockwood(ASCRS)问卷评估生活质量(QOL)，用克利夫兰大小便失禁评分法评估大便可控性。结果末次随访时使用TAI的中位时间为29(15~46)个月。灌溉用水量的中位数为900(500-1500)毫升。白天(基线，8[4-12]；最后一次随访，1[1-2])和夜间(基线，3[2-5]；最后一次随访，0[0-0])排便次数显著减少。术后克利夫兰大小便失禁评分由基线的17分[15~20分]降至末次随访的5分[4分~9分]，SF-36心理部分及Rockwood生活质量量表各领域评分均有改善。结论经肛门冲洗是治疗前切除术综合征的一种有效方法，可明显改善患者的大小便失禁评分和生活质量。
Aim Transanal irrigation (TAI) has been reported to be a cheap and effective treatment for the 'anterior resection syndrome (ARS)'. This study aimed to evaluate its effect on the quality of life (QOL) of patients suffering from ARS.Method In a prospective study involving two colorectal centres, 14 patients (11 male; median age 68 (45-80) years) were included in the study. The median duration of ARS was 19 (9-48) months. Themedian number of defaecations was 8 (4-12)/day and 3 (2-5)/night. All patients were trained to perform TAI using the Peristeen (TM) System under the guidance of a stoma nurse. Anal physiology was performed, quality of life (QOL) was estimated by the SF-36 and Rockwood (ASCRS) questionnaires and continence by the Cleveland Incontinence Score.Results At the last follow up the median time of using TAI was 29 (15-46) months. The median volume of water used for the irrigation was 900 (500-1500) ml.There was a significant decrease in the number of defaecations during the day (baseline, 8 [4-12]; last follow up, 1 [1-2]) and at night (baseline, 3 [2-5]; last follow up, 0 [0-0]). The Cleveland Incontinence Score fell from 17 [15-20] (baseline) to 5 [4-9] (last follow up) and the mental component of the SF-36 and all domains of the Rockwood QOL instrument improved.Conclusion Transanal irrigation is an effective treatment of anterior resection syndrome and results in a marked improvement of the continence score and QOL.