功能性便秘的儿童直肠测量术的临床实用性:直肠测量术可以帮助预测治疗反应吗?
Dhiren Patel1, Courtney Decker2, Leonel Rodriguez3
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, SSM Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St Louis, MO 63104, USA.
阳门测量 (ARM) 有效地预测了儿科功能性便秘的治疗成功. 特定的ARM发现,如低静止压和异常排便动作,有助于指导治疗并识别需要手术的患者.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 胃肠道运动障碍 胃肠道运动障碍
- 诊断工具 诊断工具 诊断工具
背景情况:
- 直肠测量 (ARM) 对于诊断儿童直肠运动障碍至关重要.
- 它对儿科功能性便秘治疗反应的预测价值尚未得到充分理解.
研究的目的:
- 评估ARM在预测儿科功能性便秘治疗反应中的有效性.
- 评估ARM在识别可能需要手术的患者中的作用.
主要方法:
- 对327名接受ARM治疗的儿科患者 (2018年1月至2022年7月) 的回顾性图表审查.
- 分析关键的ARM参数:门静止压力,直抑制反射 (RAIR),直感觉,和熊下机动 (BDM).
- 通过增加肠道排便或减少失禁来定义的治疗反应;手术干预也被跟踪.
主要成果:
- 总体治疗反应率为40.7%;刺激性药显示了48%的反应.
- 较低的门休息压力和延迟的直肠感觉与更好的结果相关.
- 异常的BDM预测反应不佳,而异常的RAIR表明手术的可能性更高.
结论:
- 在预测儿科功能性便秘的治疗结果方面,ARM具有重要作用.
- 它有助于识别患有不协同排便的患者,以便针对性早期干预.
- ARM协助诊断希尔施普朗格病 (HD) 和指导管理.
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