Obstructed defecation.
Obstructed defecation.
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DOI：
10.1046/j.1463-1318.2003.00497.x
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发表时间：
2003-07-01
期刊：
影响因子：
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通讯作者：
Penninckx, F
中科院分区：
文献类型：
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作者：
D'Hoore, A;Penninckx, F
背景：在过去的十年里，我们对盆底功能和功能障碍的认识有了显著的提高。一个更合理的诊断和治疗方法是现在可能的一组便秘患者由于排便受阻（OD）.METHODS：审查是基于文献检索使用PubMed数据库，主要集中在最近的文献解决subject.RESULTS：排便受阻发生在约7%的成年人。不同的病理生理机制，无论是功能或解剖，最终导致OD。不同的检查（排粪造影、气囊排空试验、测压、肌电图、结肠通过时间测量）在量化问题中起重要作用。这些测试并非没有问题，因为在无症状的对照组中也发现了异常结果。此外，不同的测试之间的一致性较差，与肿瘤学的相关性较差。因此，对于大多数综合征，包括生物反馈在内的保守治疗是合适的。手术可以产生良好的结果，在选定的cases.CONCLUSION：评分系统和定量测试的验证仍然需要。应采用更统一和严格的不等式标准，使治疗方法具有可比性。选择合适的患者进行手术是手术成功的关键。
BACKGROUND: In the last decade our understanding of pelvic floor function and dysfunction has improved significantly. A more rational diagnostic and therapeutic approach is now possible for the group of patients with constipation due to obstructed defecation (OD).METHODS: The review is based on a literature search using the PubMed database focusing mainly on recent literature addressing the subject.RESULTS: Obstructed defecation occurs in about 7% of the adult population. Different pathophysiological mechanisms, either functional or anatomical, eventually lead to OD. Different tests (defecography, balloon evacuation test, manometry, electromyography, colonic transit time measurementmanometry) play an important role to quantify the problem. These tests are not without problems as abnormal results are also found in asymptomatic controls. Also, there is poor agreement between different tests and a poor correlation with symptomatology. Thus, for most syndromes conservative treatment including biofeedback is appropriate. Surgery can yield excellent results in selected cases.CONCLUSION: Validation of scoring systems and quantitative tests is still needed. More uniform and strict criteria for anismus should be applied to make therapeutic approaches comparable. Appropriate selection of patients for surgery is the key to success.