ObjectiveTo systematically evaluate the related factors of constipation in patients with stroke. MethodsCochrane Library, PubMed, Web of Science, Embase, CNKI, VIP, Wanfang and China Biomedical Literature Database were searched by computer, and the retrieval time was set to May 2022. Case-control studies, cohort studies and cross-sectional studies on stroke and constipation were selected. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 13 studies involving 2 834 patients were included. Meta-analysis showed that age [odds ratio (OR) =2.54, 95% confidence interval (CI) (1.36, 3.73), P<0.001], lesion location [OR=1.98, 95%CI (1.27, 3.11), P=0.003], National Institutes of HealthStroke Scale score [OR=0.40, 95%CI (0.10, 0.70), P=0.010], hemiplegia [OR=4.31, 95%CI (2.59, 7.17), P<0.001], dysphagia [OR=2.32, 95%CI (1.27, 4.25), P=0.006], antidepressants [OR=2.33, 95%CI (1.62, 3.34), P<0.001], BI score [OR=−17.08, 95%CI (−33.07, −1.08), P=0.04], eating pattern [OR=4.18, 95%CI (1.16, 15.09), P=0.030], drinking water volume ≥800 mL [OR=0.30, 95%CI (0.19, 0.46), P<0.001] might be the influencing factors of constipation in patients after stroke. The results of sensitivity analysis showed that age, education level, diabetes, smoking, stroke type, lesion location, diuretic and BI score might be the influencing factors of constipation after stroke (P<0.05). The results of bias analysis suggest that publication bias is less likely. Conclusions There are many risk factors for constipation in patients with stroke. Current evidence shows that age, diabetes, smoking and other 11 factors may be risk factors for stroke constipation, while high education level and drinking water ≥800 mL may be protective factors, and the other influencing factors have not been determined and need further study.
Objective Both stapled transanal rectal resection (STARR) and vaginal bridge repair are new operative techniques for treatment of rectocele transanal and transvaginal, respectively. In this study we observe the clinical outcomes for STARR as compared with vaginal bridge repair procedure. Methods The clinical data of 31 patients with obstructive defecation syndrome from January 2007 to May 2009 were retrospectively analyzed. The patients were divided into 2 groups according to different operative approach: STARR group (n=18) and bridge repair suture group (n=13). The clinical outcomes observed were operative time, blood loss, length of stay, cost of hospitalization, complication and the improvement of obstructed defecation syndrome. Results There was no difference in the age and severity in the patients of two groups. Evaluation of the clinical outcomes showed 16 (88.9%) patients in the STARR group and 6 (46.2%) in the bridge repair suture group reported improvement in symptoms (P=0.017). STARR had a shorter operative time (24.6 min vs. 33.2 min， Plt;0.01), less estimated blood loss (3.9 ml vs. 16.2 ml， Plt;0.01), more costly (10 743 yuan vs. 3 543 yuan, Plt;0.01) and a higher anal incontinenc rate but reversible. The length of stay was similar (average 6 d). Conclusion The stapled transanal rectal resection procedure is more superior to the vaginal bridge repair suture for improvement of obstructed defecation syndrome from rectocele, however, it has a higher cost and some patient with reversible slight anal incontinence after surgery.
ObjectiveTo explore the clinical effect of healthy education on functional constipation caused by unhealthy lifestyle, and to analyze the disadvantages affecting the curative effect. MethodsA total of 167 cases of functional constipation from February 2009 to February 2012 were included. All of the patients were followed up for one year. We collected clinical data of curative effect and influencing factors, determined the clinical value of healthy education, and analyzed the influence of different factors on the curative effect of healthy education. ResultsThe total curative effect after one-year follow-up was 84.4%. The curative effect in elderly patients was significantly higher than that in middle-aged ones (P<0.05). The curative effect in urban patients was remarkably higher than that in rural ones (P<0.05). And the curative effect of patients with college degree wass much higher than that in patients with education background of primary school or below (P<0.05). ConclusionHealthy education has important value on releasing and eliminating functional constipation caused by unhealthy lifestyle. And it needs individual education aimed at patients with different age, education degree, and domicile.
Objective To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. ConclusionLung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.
目的 评价中药灌肠治疗各型便秘的疗效。 方法 计算机检索CBM、VIP、CNKI及Cochrane图书馆临床对照试验数据库等，查找符合纳入标准的随机对照试验，文献检索时间均从建库截至2012年5月。并按Cochrane系统评价手册的文献质量评价办法评价纳入研究的方法学质量，而后提取相关数据用Rev Man 5.1软件进行Meta分析。 结果 最终纳入15篇随机对照试验，共1 137名受试者。结果显示：中药灌肠治疗各型便秘的效果优于口服药、肥皂水灌肠、开塞露等其他治疗，OR值及相应95%CI分别为6.6（2.61，16.69）、5.46（2.57，11.60）、6.54（2.41，17.70）。 结论 中药灌肠治疗便秘有一定疗效且相对安全。由于纳入分析的研究质量差异较大，因此有必要进行大样本、多中心、随机、双盲的对照试验，以进一步证实其临床疗效。
Objective To investigate the express of ERβ protein in female slow transit constipation (STC) patients. Methods Immunohistochemistry and Western blot technique were used to detect the distribution and expression of estrogen receptor β (ERβ) protein of 20 patients with STC and 20 aged-matched controls. Results ERβ expressions were detected in mucous layer, myenteric nerve plexus and submucous nerve plexus in two groups. In comparison with the control group, the expression of ERβ protein of STC group was much lower (Plt;0.01). The expression of ERβ protein of sigmoid colon in STC group was significantly lower than that in control group (Plt;0.05). Conclusion The expression of ERβ protein decreased in myenteric and submucous nerve plexus of sigmoid colon tissues may involve in the pathogenesis of STC.
Objective To explore the medium- and long-term clinical effects of procedure for prolapse and hemorrhoids (PPH) combined with Block operation for obstructed defecation syndrome (ODS). Methods Clinical data of 187 patients with ODS caused by rectocele (RE) who received PPH+Block operation or pure PPH operation in The Chaoyang City Central Hospital from Mar. 2011 to May. 2013, were collected retrospectively, in which 95 patients underwent PPH+Block operation (PPH+Block group) and 92 patients underwent PPH operation (PPH group). Compared the postoperative Longo’s score, postoperative clinical effect, operative effect, and recurrence rate between the 2 groups. Results ① The postoperative Longo’s score: the postoperative Longo’s scores of the PPH+Block group were both lower than those of the PPH group at 1- and 3-year after operation (P<0.05). ② Postoperative curative effect: the total effective rate of the PPH+Block group and the PPH group were both 100%, but the clinical effect of the the PPH+Block group was better than that of the PPH group (Z=–10.15, P<0.05). ③ Operative effect: there was no statistical significance on operative time, intraoperative blood loss, returned to normal activity time, hospital stay, and postoperative visual analogy score (VAS) between the 2 groups (P>0.05). In addition, there were no statistical significance on the incidences of urinary retention, hematochezia, exhaust anal incontinence, and anal fissure between the 2 groups (P>0.05), but the incidence of urgent or high anal straining feeling in the PPH+Block group was significantly higher than that of the PPH group (P<0.05). ④ Medium- and long-term recurrence rate: the recurrence rate of 1-year after operation was similar between these2 groups (P>0.05), but the recurrence rate of 3-year after operation in the PPH+Block group was significantly lower than that of the PPH group (P<0.05). Conclusions The medium clinical effect has no obvious difference between PPH+Block and PPH operation, but the long-term recurrence rate of the former is lower than that of the latter, and the medium- and long-term effect is stable in PPH+Block operation for ODS caused by RE.