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评估发泄的良性疾病发展的危险因素:一个外科的视角
P Chaichanavichkij1, M Hartmann2, S M Scott3
1National Bowel Research Centre and GI Physiology Unit, Centre for Neuroscience, Surgery & Trauma, Blizard Institute, Queen Mary University of London, 1st Floor, Abernethy Building, 2 Newark Street, London, E1 2AT, UK. p.chaichanavichkij@qmul.ac.uk.
阿片类药物镇痛,饮食障碍和滥用史是慢性便秘的关键危险因素. 对于便失禁,严重的分娩水,仪器分娩和祖母多亲子是显著的风险. 这些发现有助于预防疾病.
科学领域:
- 胃肠病学和结肠直肠外科手术
- 流行病学和公共卫生.
- 临床风险因素分析
背景情况:
- 发表的证据中的异质性导致了对缺陷问题的风险因素的不确定性.
- 识别和理解这些风险因素对于制定有针对性的预防和逆转策略至关重要.
- 便失禁和慢性便秘代表了影响生活质量的重大便疾病.
研究的目的:
- 系统地识别和评估与慢性便秘相关的关键风险因素.
- 系统地识别和评估与便失禁相关的关键风险因素.
- 使用专家共识建立风险因素重要性的证据基础.
主要方法:
- 从科学文献中编制了一份潜在风险因素的综合清单.
- 50名英国骨盆地协会结直肠外科专家使用德尔菲技术匿名评估风险因素.
- 风险因素被分类为独立因素,辅助因素或非风险因素,独立因素按重要性评分 (1-10).
主要成果:
- 对于慢性便秘,主要的独立风险因素包括阿片类药物止痛 (7.87),饮食障碍 (7.80) 和滥用史 (7.70).
- 女性性别 (6.60) 是便秘的独立风险因素,而年龄的增加是辅助因素.
- 对于便失禁,独立的危险因素是第三/第四度撕裂 (8.88),仪器分娩 (8.47) 和大多对 (8.00). 年龄上升 (7.41) 和女性性别 (7.58) 也是独立的风险因素.
结论:
- 德尔菲的方法成功地确定和优先考虑了慢性便秘和便失禁的几个关键风险因素.
- 这些经过验证的风险因素为开发缺陷性疾病的预测贝叶斯模型提供了基础.
- 专家的共识强调了在临床实践和研究中需要注意的特定可修改和不可修改的因素.
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