炎症性肠病患者大便失禁现状及管理的研究进展

doi:10.3761/j.issn.0254-1769.2022.21.019

摘要/Abstract

摘要：

大便失禁是炎症性肠病患者常见的症状之一，常导致患者日常人际交往和活动受限，严重影响患者的心理状态、生活及工作质量。该文概述了炎症性肠病患者大便失禁的概念、发生现状、不良影响、评估工具以及干预措施，旨在为该类患者大便失禁的管理及相关临床研究的开展提供参考依据。

关键词: 炎症性肠病, 大便失禁, 护理, 综述

Abstract:

Fecal incontinence is one of the common symptoms of patients with inflammatory bowel disease，which often leads to the limitation of daily interpersonal communication and activities，and seriously affects the psychological state，life and work quality of patients. This paper summarized the concept，current situation，adverse effects，assessment tools and intervening measures of fecal incontinence in patients with inflammatory bowel disease，so as to provide references for the symptom management of fecal incontinence in patients with inflammatory bowel disease and the development of related clinical research.

Key words: Inflammatory Bowel Disease, Fecal Incontinence, Nursing Care, Review

薛文俊, 杨嫚, 申丽香. 炎症性肠病患者大便失禁现状及管理的研究进展[J]. 中华护理杂志, 2022, 57(21): 2682-2688.

XUE Wenjun, YANG Man, SHEN Lixiang. Research progress on status and management of fecal incontinence for patients with inflammatory bowel disease[J]. Chinese Journal of Nursing, 2022, 57(21): 2682-2688.

参考文献 47

[1]	Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and pre-valence of inflammatory bowel disease in the 21st century:a systematic review of population-based studies[J]. Lancet, 2017, 390(10114):2769-2778. DOI URL
[2]	Mancina RM, Pagnotta R, Pagliuso C, et al. Gastrointestinal symp-toms of and psychosocial changes in inflammatory bowel disease:a nursing-led cross-sectional study of patients in clinical remission[J]. Medicina(Kaunas), 2020, 56(1):E45.
[3]	Subasinghe D, Navarathna NM, Samarasekera DN. Faecal incontinence and health related quality of life in inflammatory bowel disease patients:findings from a tertiary care center in South Asia[J]. World J Gastrointest Pharmacol Ther, 2016, 7(3):447-452. DOI PMID
[4]	Norton C, Dibley LB, Bassett P. Faecal incontinence in inflammatory bowel disease:associations and effect on quality of life[J]. J Crohns Colitis, 2013, 7(8):e302-e311. DOI URL
[5]	Kemp K, Dibley L, Chauhan U, et al. Second N-ECCO consensus statements on the European nursing roles in caring for patients with Crohn’s disease or ulcerative colitis[J]. J Crohns Colitis, 2018, 12(7):760-776. DOI URL
[6]	Rao SS, American College of Gastroenterology Practice Parameters Committee. Diagnosis and management of fecal incontinence. American College of Gastroenterology Practice Parameters Committee[J]. Am J Gastroenterol, 2004, 99(8):1585-1604. PMID
[7]	Wald A, Bharucha AE, Limketkai B, et al. ACG clinical guidelines:management of benign anorectal disorders[J]. Am J Gastroenterol, 2021, 116(10):1987-2008. DOI URL
[8]	Brown HW, Wexner SD, Segall MM, et al. Accidental bowel lea-kage in the mature women’s health study:prevalence and predictors[J]. Int J Clin Pract, 2012, 66(11):1101-1108. DOI PMID
[9]	Paquette IM, Varma MG, Kaiser AM, et al. The American Society of Colon and Rectal Surgeons’ clinical practice guideline for the treatment of fecal incontinence[J]. Dis Colon Rectum, 2015, 58(7):623-636. DOI PMID
[10]	Maeda K, Yamana T, Takao Y, et al. Japanese practice guidelines for fecal incontinence part 1-definition,epidemiology,etiology,pathophysiology and causes,risk factors,clinical evaluations,and symptomatic scores and QoL questionnaire for clinical evaluations-English version[J]. J Anus Rectum Colon, 2021, 5(1):52-66. DOI URL
[11]	Kurt S, Caron B, Gouynou C, et al. Faecal incontinence in inflammatory bowel disease:the Nancy experience[J]. Dig Liver Dis, 2022, 2:S1590-S8658.
[12]	Vollebregt PF, van Bodegraven AA, Markus-de Kwaadsteniet TML, et al. Impacts of perianal disease and faecal incontinence on quality of life and employment in 1092 patients with inflammatory bowel disease[J]. Aliment Pharmacol Ther, 2018, 47(9):1253-1260. DOI URL
[13]	齐妍妍, 王爱平. 炎症性肠病患者大便失禁现状调查及其影响因素分析[J]. 中华现代护理杂志, 2018, 24(19):2323-2327.
	Qi YY, Wang AP. Current status and predictors of fecal incontinence in patients with inflammatory bowel disease[J]. Chin J Mod Nurs, 2018, 24(19):2323-2327.
[14]	Piltan F, Toma RN, Shon D, et al. Prevalence and risk factors associated with depressive mood in Korean patients with fecal incontinence[J]. Sensors(Basel), 2022, 22(2):539.
[15]	Pittet V, Vaucher C, Froehlich F, et al. Patient self-reported concerns in inflammatory bowel diseases:a gender-specific subjective quality-of-life indicator[J]. PLoS One, 2017, 12(2):e0171864. DOI URL
[16]	罗丹, 林征, 卞秋桂, 等. 炎症性肠病患者感知病耻感现状及其对生活质量、服药依从性和心理状态的影响[J]. 中华护理杂志, 2018, 53(9):1078-1083.
	Luo D, Lin Z, Bian QG, et al. Perceived stigma in patients with inflammatory bowel disease and its effect on psychology,medication compliance and quality of life[J]. Chin J Nurs, 2018, 53(9):1078-1083.
[17]	Conley S, Proctor DD, Jeon S, et al. Symptom clusters in adults with inflammatory bowel disease[J]. Res Nurs Health, 2017, 40(5):424-434. DOI PMID
[18]	Bernstein CN, Hitchon CA, Walld R, et al. Increased burden of psychiatric disorders in inflammatory bowel disease[J]. Inflamm Bowel Dis, 2019, 25(2):360-368. DOI PMID
[19]	顾芳臣, 林征, 尚星辰, 等. 炎症性肠病患者症状群评估量表的编制及信效度检验[J]. 中华护理杂志, 2020, 55(12):1819-1824. DOI
	Gu FC, Lin Z, Shang XC, et al. Construction and preliminary application of Symptom Cluster Scale for Inflammatory Bowel Disease[J]. Chin J Nurs, 2020, 55(12):1819-1824. DOI
[20]	万捷. 溃疡性结肠炎组织学炎症负担评估与结直肠癌及癌前病变的相关性研究[D]. 济南: 山东大学, 2021.
	Wan J. Histological evaluation of inflammatiory burden in ulcerative colitis and its correlation with colorectal cancer and precursors of colonic carcinoma[D]. Jinan: Shandong University, 2021.
[21]	Mosli MH, Alamri AA, Saadah OI. Work and school absente-eism in inflammatory bowel disease patients in Jeddah,Saudi Arabia:a cross-sectional study[J]. Saudi J Med Med Sci, 2021, 9(2):159-166. DOI URL
[22]	Norton C, Dibley L. Help-seeking for fecal incontinence in people with inflammatory bowel disease[J]. J Wound Ostomy Continence Nurs, 2013, 40(6):631-638. DOI URL
[23]	周美景, 罗丹, 林征, 等. 炎症性肠病患者自我管理行为的影响因素分析[J]. 中华护理杂志, 2021, 56(4):550-555. DOI
	Zhou MJ, Luo D, Lin Z, et al. Analysis of influencing factors of self-management behavior in patients with inflammatory bowel disease[J]. Chin J Nurs, 2021, 56(4):550-555. DOI
[24]	Paulides E, Daker C, Frampton C, et al. Overcoming workplace disability in IBD patients:an observational study[J]. Inflamm Intest Dis, 2020, 5(2):84-92. DOI PMID
[25]	李晓婷, 刘云, 任建安, 等. 克罗恩病患者健康相关生活质量及其影响因素调查[J]. 中华护理杂志, 2014, 49(1):70-75.
	Li XT, Liu Y, Ren JN, et al. The level and influencing factors of health related quality of life in patients with Crohn disease[J]. Chin J Nurs, 2014, 49(1):70-75.
[26]	Williet N, Sarter H, Gower-Rousseau C, et al. Patient-reported outcomes in a French nationwide survey of inflammatory bowel disease patients[J]. J Crohns Colitis, 2017, 11(2):165-174. DOI PMID
[27]	World Health Organization. International classification of func-tioning, disability and health:ICF[R]. Geneva:WHO, 2001.
[28]	Bian DS, Jiang YM, Gu YB, et al. Body mass index and disease activity are associated with moderate to severe disability in Crohn’s disease:a cross-sectional study in Shanghai[J]. Front Med(Lausanne), 2021, 8:662488.
[29]	Jorge JM, Wexner SD. Etiology and management of fecal incontinence[J]. Dis Colon Rectum, 1993, 36(1):77-97. PMID
[30]	D’Amico F, Wexner SD, Vaizey CJ, et al. Tools for fecal incontinence assessment:lessons for inflammatory bowel disease trials based on a systematic review[J]. United European Gastroenterol J, 2020, 8(8):886-922. DOI URL
[31]	惠慧, 徐东燕, 赵海剑, 等. 缓解期溃疡性结肠炎患者功能性肠道症状调查分析[J]. 中华消化病与影像杂志(电子版), 2022, 12(1):16-19.
	Hui H, Xu DY, Zhao HJ, et al. Investigation and analysis of functional intestinal symptoms in patients with remission ulcerative colitis[J]. Chin J Dig Med Imageology Electron Ed, 2022, 12(1):16-19.
[32]	Vaizey CJ, Carapeti E, Cahill JA, et al. Prospective comparison of faecal incontinence grading systems[J]. Gut, 1999, 44(1):77-80. PMID
[33]	Rockwood TH, Church JM, Fleshman JW, et al. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence:the fecal incontinence severity index[J]. Dis Colon Rectum, 1999, 42(12):1525-1532. PMID
[34]	Cotterill N, Norton C, Avery KN, et al. Psychometric evaluation of a new patient-completed questionnaire for evaluating anal incontinence symptoms and impact on quality of life:the ICIQ-B[J]. Dis Colon Rectum, 2011, 54(10):1235-1250. DOI PMID
[35]	Dibley L, Norton C, Cotterill N, et al. Development and initial validation of a disease-specific bowel continence questionnaire for inflammatory bowel disease patients:the ICIQ-IBD[J]. Eur J Gastroenterol Hepatol, 2016, 28(2):233-239. DOI URL
[36]	Rockwood TH, Church JM, Fleshman JW, et al. Fecal Incontinence Quality of Life Scale:quality of life instrument for patients with fecal incontinence[J]. Dis Colon Rectum, 2000, 43(1):9-16. PMID
[37]	王晓慧. 女性改良自我形象评分与粪失禁生活质量问卷中文版本研制与中国人群验证[D]. 北京: 北京协和医学院, 2014.
	Wang XH. Development and validation of Chinese version of Modified Body Image Sacle and Fecal Incontinence Quality of Life Scale in Chinese population[D]. Beijing: Peking Union Medical College, 2014.
[38]	高雪晓, 朱兰, 於四军, 等. 简体中文版粪失禁生活质量问卷信度和效度分析[J]. 中华医学杂志, 2018, 98(11):813-817.
	Gao XX, Zhu L, Yu SJ, et al. Reliability and validity of the simplified Chinese version of the Fecal Incontinence Quality of Life Questionnaire in the patients with fecal incontinence[J]. Natl Med J China, 2018, 98(11):813-817.
[39]	王新. 孕妇盆底功能状况调查及盆底肌锻炼持续性指导效果研究[D]. 广州: 南方医科大学, 2012.
	Wang X. Prevalence of pelvic floor dysfunction during pregnancy and study on the effect of nursing intervention of pelvic floor muscle training[D]. Guangzhou: Southern Medical University, 2012.
[40]	Khera AJ, Chase JW, Salzberg M, et al. Systematic review:pe-lvic floor muscle training for functional bowel symptoms in inflammatory bowel disease[J]. JGH Open, 2019, 3(6):494-507. DOI URL
[41]	Khera AJ, Chase JW, Salzberg M, et al. Gut-directed pelvic floor behavioral treatment for fecal incontinence and constipation in patients with inflammatory bowel disease[J]. Inflamm Bowel Dis, 2019, 25(3):620-626. DOI PMID
[42]	Khera AJ, Chase JW, Stillman BC, et al. Pelvic floor behavioral treatment for fecal incontinence and constipation in quiescent inflammatory bowel disease[J]. Scand J Gastroenterol, 2022:1-7.
[43]	叶颖江, 申占龙, 王杉. 骶神经刺激疗法在治疗排粪失禁中的应用[J]. 中华胃肠外科杂志, 2014, 17(3):297-300.
	Ye YJ, Shen ZL, Wang S. Application of sacral nerve stimulation therapy in the treatment of fecal incontinence[J]. Chin J of Gastrointest Surg, 2014, 17(3):297-300.
[44]	姚一博, 肖长芳, 王琛. 大便失禁的非手术治疗研究进展[J]. 结直肠肛门外科, 2021, 27(5):423-427.
	Yao YB, Xiao CF, Wang C. Advancements in non-surgical treatment of fecal incontinence[J]. J Colorectal Anal Surg, 2021, 27(5):423-427.
[45]	Gu P, Kuenzig ME, Kaplan GG, et al. Fecal incontinence in inflammatory bowel disease:a systematic review and meta-analysis[J]. Inflamm Bowel Dis, 2018, 24(6):1280-1290. DOI URL
[46]	Proudfoot H, Norton C, Artom M, et al. Targets for interventions for faecal incontinence in inflammatory bowel disease:a systematic review[J]. Scand J Gastroenterol, 2018, 53(12):1476-1483. DOI URL
[47]	Norton C, Dibley LB, Hart A, et al. Faecal incontinence intervention study(FINS):self-management booklet information with or without nurse support to improve continence in people with inflammatory bowel disease:study protocol for a randomized controlled trial[J]. Trials, 2015, 16:444. DOI URL