大便失禁:当前的知识和观点。

A. Benezech, M. Bouvier, V. Vitton
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引用次数: 30

摘要

大便失禁(FI)是一种致残且常见的症状,其患病率可在总人口的5%至15%之间变化。它对生活质量有特别的负面影响。目前有许多工具可用于治疗FI,从保守措施到侵入性手术治疗。保守治疗包括饮食、各种药物、肛肠康复、胫后神经刺激、经肛冲洗等。如有需要,患者可采用微创入路,如骶神经调节或顺行冲洗。在某些情况下,建议手术治疗,主要是肛门外括约肌修复。虽然这些不同的治疗选择是可用的,但新技术的出现给病人带来了新的希望。此外,它们大多是非侵入性的,如局部应用α1-肾上腺素能受体激动剂、干细胞注射、直肠注射肉毒杆菌毒素、针灸。新的更具侵入性的技术也出现了,如肛门磁性括约肌和三门肌转位。本文综述了目前FI的主要治疗方法和发展中的治疗工具。
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Faecal incontinence: Current knowledges and perspectives.
Faecal incontinence (FI) is a disabling and frequent symptom since its prevalence can vary between 5% and 15% of the general population. It has a particular negative impact on quality of life. Many tools are currently available for the treatment of FI, from conservative measures to invasive surgical treatments. The conservative treatment may be dietetic measures, various pharmacological agents, anorectal rehabilitation, posterior tibial nerve stimulation, and transanal irrigation. If needed, patients may have miniinvasive approaches such as sacral nerve modulation or antegrade irrigation. In some cases, a surgical treatment is proposed, mainly external anal sphincter repair. Although these different therapeutic options are available, new techniques are arriving allowing new hopes for the patients. Moreover, most of them are non-invasive such as local application of an α1-adrenoceptor agonist, stem cell injections, rectal injection of botulinum toxin, acupuncture. New more invasive techniques with promising results are also coming such as anal magnetic sphincter and antropylorus transposition. This review reports the main current available treatments of FI and the developing therapeutics tools.
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