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美国脊柱裂项目中肠道和膀胱控尿情况的差异:一项描述性研究。

Variation in bowel and bladder continence across US spina bifida programs: A descriptive study.

作者信息

Freeman Kurt A, Castillo Heidi, Castillo Jonathan, Liu Tiebin, Schechter Michael, Wiener John S, Thibadeau Judy, Ward Elisabeth, Brei Timothy

机构信息

Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA.

Department of Developmental-Behavioral Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA.

出版信息

J Pediatr Rehabil Med. 2017 Dec 11;10(3-4):231-241. doi: 10.3233/PRM-170450.

Abstract

PURPOSE

Continence is low in individuals with spina bifida, but published prevalence varies markedly across studies. The objective of this study was to examine bladder and bowel continence among patients served by multidisciplinary clinics participating in the National Spina Bifida Patient Registry and to examine whether variation in prevalence exists across clinics.

METHODS

Data were obtained from patients 5 years and older from March 2009 to December 2012. Data were gathered at clinic visits using standardized definitions.

RESULTS

Data from 3252 individuals were included. Only 40.8% of participants were continent of urine; 43% were continent of stool. Bladder and bowel continence differed by spina bifida type, with those with myelomeningocele having significantly lower reported prevalence of continence than those with other forms of spina bifida. Bladder and bowel continence varied across registry sites. Adjustment based on demographic and condition-specific variables did not make substantive differences in prevalence observed.

CONCLUSION

Less than half of spina bifida patients served in multidisciplinary clinics report bladder or bowel continence. Variability in prevalence was observed across clinics. Further research is needed to examine if clinic-specific variables (e.g., types of providers, types of interventions used) account for the observed variation.

摘要

目的

脊柱裂患者的控尿能力较低,但各研究报告的患病率差异显著。本研究的目的是调查参与国家脊柱裂患者登记处的多学科诊所所服务患者的膀胱和肠道控尿情况,并研究各诊所的患病率是否存在差异。

方法

数据来自2009年3月至2012年12月5岁及以上的患者。在诊所就诊时使用标准化定义收集数据。

结果

纳入了3252名个体的数据。只有40.8%的参与者能自主控制排尿;43%能自主控制排便。膀胱和肠道控尿情况因脊柱裂类型而异,脊髓脊膜膨出患者报告的控尿患病率明显低于其他类型脊柱裂患者。各登记处的膀胱和肠道控尿情况各不相同。根据人口统计学和疾病特异性变量进行调整后,观察到的患病率没有实质性差异。

结论

在多学科诊所接受服务的脊柱裂患者中,不到一半的人报告能自主控制膀胱或肠道。各诊所的患病率存在差异。需要进一步研究,以检查特定诊所变量(如提供者类型、所采用的干预措施类型)是否能解释观察到的差异。

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