骶神经刺激治疗功能性大便失禁的短期疗效分析

叶光耀; 张诚; 崔喆

doi:10.12025/j.issn.1008-6358.2020.20192189

骶神经刺激治疗功能性大便失禁的短期疗效分析

Short-term efficacy of sacral nerve stimulation for functional fecal incontinence: a pilot study

摘要

摘要:
目的评价骶神经刺激术（sacral nerve stimulation，SNS）对无括肌缺陷大便失禁（fecal incontinence，FI）患者的治疗效果。
方法选择无括约肌功能缺陷的2例FI患者，进行为期2周的骶神经刺激测试治疗（peripheral nerve evaluation，PNE；SNS的体外体验治疗）。测试过程中记录排便情况，每周FI次数减少≥ 50%时为治疗有效；同时进行克利夫兰FI评分表（CCF-FIS）及FI生活质量（FIQL）评分。
结果 2例FI患者在测试期结束时每周FI次数均减少≥ 50%；排便急迫时控便时间由 < 1 min延长为1~5 min。2例患者的CCF-FIS评分分别由治疗前的15、16分降至治疗后的3、3分。2例患者治疗后FIQL明显改善。2例患者均永久植入骶神经刺激器。
结论 SNS在短期内能安全、有效地改善无括约肌缺陷FI患者的临床症状，提高其生活质量。

Abstract:
Objective To assess therapeutic efficacy of sacral nerve stimulation (SNS) for patients with fecal incontinence (FI) without sphincter function defect.
Methods The screening stimulation of 2 weeks was performed in two FI patients without sphincter function defect. The defecation was recorded during the test, and it was effective when FI time reduce ≥ 50% in a week. Cleveland Clinic Florida fecal incontinence score (CCF-FIS) and FI quality of life score (FIQL) were evaluated.
Results At the end of screening, the FI times of 2 patients reduced more than 50%. Urgent defecation control time increased from < 1 min to 1-5 min. CCF-FIS score of 2 patients decreased from 15, 16 to 3, 3, respectively. FIQL scale also got a significant improvement. The stimulator was implanted in 2 patients.
Conclusions SNS is safe and effective in FI patients without sphincter defect in short term, and could improve the life quality of the patients.

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