CAJ | 학술논문

目的：观察骶神经调节术（SNM）治疗顽固性便秘的临床效果。方法第四军医大学西京消化病医院消化外科于2013年1月至2014年1月期间，采用骶神经调节测试系统经皮穿刺，刺激第3骶神经根，治疗7例复杂便秘患者，其中4例患者既往进行过至少1次的便秘手术。通过排粪日记、Cleveland便秘评分及视觉模拟评分（VAS）进行疗效评价。结果7例患者在接受体外临时测试治疗后，便秘症状均明显改善。其中6例接受永久性骶神经调节器植入术，围手术期未见并发症。术后随访中位时间4（2～12）月，6例患者的每周排粪次数由治疗前（0．6±0．5）次／周，增加到（8．0±2．5）次／周（P＜0．01）；排粪时间从（22．9±11．5） min减少到（3．7±0．8） min（P＜0．01）；Cleveland便秘评分从（24．6±4．2）分下降到（9．0±0．9）分（P＜0．01）；VAS评分从（8．1±0．9）分增加到（82．5±5．2）分（P＜0．01）。结论 SNM是治疗顽固性便秘的一种微创而安全有效的新方法。
목적：관찰저신경조절술（SNM）치료완고성편비적림상효과。방법제사군의대학서경소화병의원소화외과우2013년1월지2014년1월기간，채용저신경조절측시계통경피천자，자격제3저신경근，치료7례복잡편비환자，기중4례환자기왕진행과지소1차적편비수술。통과배분일기、Cleveland편비평분급시각모의평분（VAS）진행료효평개。결과7례환자재접수체외림시측시치료후，편비증상균명현개선。기중6례접수영구성저신경조절기식입술，위수술기미견병발증。술후수방중위시간4（2～12）월，6례환자적매주배분차수유치료전（0．6±0．5）차／주，증가도（8．0±2．5）차／주（P＜0．01）；배분시간종（22．9±11．5） min감소도（3．7±0．8） min（P＜0．01）；Cleveland편비평분종（24．6±4．2）분하강도（9．0±0．9）분（P＜0．01）；VAS평분종（8．1±0．9）분증가도（82．5±5．2）분（P＜0．01）。결론 SNM시치료완고성편비적일충미창이안전유효적신방법。
Objective To assess the efficacy of sacral neuromodulation (SNM) in patients with intractable constipation. Methods A total of 7 patients with intractable constipation were treated with pereutaneous test stimulation of the S3 nerve root and were assessed by sacral never stimulation system in our department from January 2013 to January 2014. Four of these 7 patients received operation for constipation before. The efficacy was assessed by bowel habit diary, clinic constipation scores, subjective questionnaire and clinical signs. Results The constipation symptoms were improved significantly in all the 7 patients. The frequency and volume of defecation per week were increased obviously, and the average urine was increased. Six patients underwent permanent implantation of the SNS system. After a median 4 months follow-up, the defecation frequency increased from 0.6 ±0.5 to 8.0 ±2.5 per week (P<0.01), and the defecation time decreased from (22.9 ±11.5) to (3.7 ±0.8) min (P<0.01). The Cleveland clinic constipation score decreased from 24.6±4.2 to 9.0±0.9 (P<0.01), and the visual analogue scale(VAS) score increased from 8.1±0.9 to 82.5±5.2(P<0.01). Conclusion SNM is a clinically efficacious, minimally invasive and safe new technique, which offers an alternative treatment for the patients with intractable constipation resistant to conservative treatment , especially for the patients refractory to traditional operations.