CAJ | 학술논문

目的：观察骶神经调节术（ Sacral Neuromodulation ，SNM）治疗顽固性便秘的临床效果。方法采用骶神经调节测试系统，经皮穿刺刺激调节骶神经根治疗12例顽固性便秘患者，通过排便日记、Cleveland便秘评分及患者症状评分评价疗效。结果在测试治疗阶段11例患者便秘症状明显改善，每周排便次数、排便量明显增加。其中10例接受永久性骶神经调节器植入术，永久性植入术后平均随访7．8个月（1～20个月），每周排便次数从（0．80±0．42）次增加到（8．10±2．47）次（ P＜0．01）；每次排便时间从（21．10±10．06）分钟减少到（3．70±0．67）分钟（P＜0．01）；Cleveland便秘评分从（21．10±4．99）分下降到（8．90±0．88）分（P＜0．01）；VAS评分从（9．90±3．28）分增加到（84．10±4．63）分（ P＜0．01）。结论 SNM是一种安全、可逆、有效、微创的治疗顽固性便秘的新方法，适于对传统治疗无效的顽固性便秘患者。
목적：관찰저신경조절술（ Sacral Neuromodulation ，SNM）치료완고성편비적림상효과。방법채용저신경조절측시계통，경피천자자격조절저신경근치료12례완고성편비환자，통과배편일기、Cleveland편비평분급환자증상평분평개료효。결과재측시치료계단11례환자편비증상명현개선，매주배편차수、배편량명현증가。기중10례접수영구성저신경조절기식입술，영구성식입술후평균수방7．8개월（1～20개월），매주배편차수종（0．80±0．42）차증가도（8．10±2．47）차（ P＜0．01）；매차배편시간종（21．10±10．06）분종감소도（3．70±0．67）분종（P＜0．01）；Cleveland편비평분종（21．10±4．99）분하강도（8．90±0．88）분（P＜0．01）；VAS평분종（9．90±3．28）분증가도（84．10±4．63）분（ P＜0．01）。결론 SNM시일충안전、가역、유효、미창적치료완고성편비적신방법，괄우대전통치료무효적완고성편비환자。
Objective To assess the clinical efficacy of sacral neuromodulation (SNM)in patientswith intractable constipation.Me thods A total of 12 patients with intractable constipation were treated withpereutaneous test stimulation of the sacral nerve root and were assessed by sacral nerve stimulation system ,Then the clinical efficacy was assessed by the bowel habit diary ,the clinic constipation scores,subjectivequestionnaire and clinical signs.Results The symptoms of constipation were improved significantly in 11patients.The frequency and volume of defecation per week increased obviously .Of these 10 patients,permanent implantation of the SNM system was implemented .After a median of 7.8 months(1 ~20 months)follow-up,defecation frequency increased from (0.80 ±0.42)to(8.10 ±2.47)evacuations per week(P <0.01).There was a decrease in time spent toileting from (21.10 ±10.06)to(3.70 ±0.67) mins(P <0.01).Cleveland clinic constipation score decreased from (21.10 ±4.99)to(8.90 ±0.88)(P <0.01).Visual analogue scale(VAS)score increased from(9.90 ±3.28)to(84.10 ±4.63)(P <0.01).Conclusion SNM is a clinically efficacious,reversible,minimal invasive and safe technique,and it offers an alternativetreatment for the patients with intractable constipation resistant to conservative treatment .