获得脑损伤后的肠道功能障碍:一个范围审查
Matteo Zandalasini1, Laura Pelizzari1, Gianluca Ciardi1,2
1Department of Rehabilitative Medicine, Azienda USL Piacenza, Piacenza, Italy.
Frontiers in human neuroscience
|October 30, 2023
概括
获得脑损伤 (ABI) 后的神经性肠道功能障碍很常见,影响生活质量. 这次审查强调了有限的证据,并强调口服药作为常见的治疗方法,强调需要更好的诊断共识.
科学领域:
- 神经学 神经学
- 胃肠病学 胃肠病学
- 康复医学 康复医学 康复医学
背景情况:
- 肠道功能障碍显著影响患者的生活质量和尊严,特别是在神经疾病中.
- 目前对神经性肠道的研究主要集中在脊髓损伤和多发性硬化症上,对获得性脑损伤 (ABI) 的数据有限.
- 神经性肠道功能障碍 (NBD) 是一种慢性疾病,在中枢神经系统疾病患者中加剧残疾和社会隔离.
研究的目的:
- 进行范围审查,以了解ABI后关于肠道功能障碍的证据的范围和性质.
- 在ABI患者中确定和介绍神经性肠道功能障碍的保守治疗选择.
- 为了突出目前的研究和临床实践的差距NBD在ABI之后.
主要方法:
- 使用PCC (人口,概念,上下文) 框架进行了范围审查:患有ABI和肠道功能障碍的患者;评估和治疗;和康复.
- 一个系统的搜索确定了相关的文献,最终包括了十篇全文文章在评论中.
- 该审查分析了现有的证据类型和在ABI中用于NBD的保守治疗方法.
主要成果:
- 口服药是ABI患者神经性肠道功能障碍最常见的记录治疗方法.
- 功能独立度量 (FIM) 分级是最常见的评估工具 (60%),其次是罗马标准;结肠过境时间用于便秘,但缺乏控制不清的工具方法.
- 在管理便秘和失禁方面存在显著的重叠,并且挑战是由诸如脊髓损伤 (SCI) 和ABI等同时存在的条件加剧的.
结论:
- 需要在康复和胃肠病学学会之间就ABI后的神经性肠道功能障碍的诊断和医疗管理达成共识.
- 目前关于ABI中NBD的证据有限,需要进一步研究有效的评估和治疗策略.
- 在ABI患者中改善NBD的管理对于提高其功能独立性和生活质量至关重要.
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