在患有膀和肠道功能障碍的儿童和青少年中,直肠直径和对帕萨克拉穿皮电神经刺激治疗的反应以及行为变化之间的关联
Noel Charlles Nunes1, Glicia Estevam de Abreu1, Eneida Regis Dourado1
1Centro de Distúrbios Urinários na Infância (CEDIMI), Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
概括
在患有膀和肠道功能障碍 (BBD) 的儿童中,直肠直径 (RD) 的增加预测了治疗后持续的功能性便秘 (FC). 这一发现强调了 RD 是评估 BBD 治疗结果的关键因素.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗成像医学成像
背景情况:
- 膀和肠道功能障碍 (BBD) 影响了许多儿童,像TENS这样的治疗是常见的.
- 功能性便秘 (FC) 经常与BBD相关,而增加的直肠直径 (RD) 与FC有关.
- 对于儿科BBD治疗结果的RD的预测价值仍然在很大程度上未被评估.
研究的目的:
- 调查治疗前直肠直径 (RD) 与诊断为膀和肠功能障碍 (BBD) 的儿童和青少年的治疗反应之间的关联.
- 确定RD是否可以作为BBD治疗后功能性便秘 (FC) 持续性的预测因素.
主要方法:
- 一组患有BBD的儿科患者 (5-17岁) 使用功能障碍排泄评分系统 (DVSS),罗马IV标准和便秘评分进行评估.
- 在治疗前,通过腹部超声波测量了直肠直径 (RD),其扩大直径定义为>3厘米.
- 统计分析包括描述性统计,二进制回归和接收器操作特征 (ROC) 曲线分析,以评估 RD 的预测能力.
主要成果:
- 在40名儿童中,37.5%出现了扩大的RD (>3厘米).
- 患有扩大RD的儿童在治疗后 (73.3%) 显着更有可能出现持续性FC,需要更多的药,并报告更严重的便秘.
- 治疗前的RD被确定为持续性FC的独立预测因子 (OR=9.56),ROC分析表明RD>3厘米的高灵敏度 (100%) 和特异性 (77.14%).
结论:
- 治疗前直肠直径 (RD) 是儿童膀和肠功能障碍 (BBD) 治疗结果的重要预测指标,特别是功能性便秘 (FC) 的持续性.
- 使用腹部超声波测量RD可以帮助识别患有治疗不响应风险较高的儿童.
- RD测量应该被认为是儿童BBD综合评估和管理的宝贵工具.
相关概念视频
Gastrointestinal Motility Disorders
Gastrointestinal or GI motility disorders are characterized by irregular gastrointestinal tract movements, disrupting food transit from the mouth to the anus. They are caused by damage or dysfunction in gut muscles or nerves. These disorders can cause symptoms such as severe constipation, diarrhea, abdominal pain, and swallowing difficulties. Disorders can affect any segment of the GI tract and range widely in severity, from common conditions like GERD to life-threatening conditions like...
Assessment of the Rectum and Anus
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Endoscopic Procedures V: ERCP
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...


