척수 손상 환자에서 입원 치료 후 신경인성 장 기능의 호전
The Change of Neurogenic Bowel Dysfunction in Spinal Cord Injury Patients during Admission
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objective: To investigate the change of neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI) patients during admission. Method: Thirty eight SCI patients were enrolled. The NBD score by Krogh was converted to the Korean-version of NBD score. The questionnaires of NBD score included questions about neurogenic bowel symptoms, signs, gender, age, duration, injury level, American spinal cord injury association impairment scale (AIS) and Spinal cord independence measure (SCIM) were used for evaluation of the functional impairment of the SCI. The Korean version of NBD score was applied to the SCI patients at the time of admission and discharge. Neurogenic bowel was treated according to scheduled bowel care. The subcomponents of bowel care protocol were education of bowel habit, abdominal massage, triggered defecation, oral medication and rectal stimulants insertion. Results: The NBD score at the time of discharge decreased significantly in all patients within three months after SCI (p＜0.001). Particularly, AIS A, C, D patients (except for cauda equina syndrome patients) (p＜0.005) showed significant decrease of NBD score. There were no significant difference of NBD score according to age, sex, injured cord level and SCIM (p＞0.05). Conclusion: We could reveal the significant improvement of NBD in patients within three months after SCI during admission. The change was more evident in AIS A, C, D patients.
Abstract
Objective: To investigate the change of neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI) patients during admission. Method: Thirty eight SCI patients were enrolled. The NBD score by Krogh was converted to the Korean-version of NBD score. The questionnaires of NBD score included questions about neurogenic bowel symptoms, signs, gender, age, duration, injury level, American spinal cord injury association impairment scale (AIS) and Spinal cord independence measure (SCIM) were used for evaluation of the functional impairment of the SCI. The Korean version of NBD score was applied to the SCI patients at the time of admission and discharge. Neurogenic bowel was treated according to scheduled bowel care. The subcomponents of bowel care protocol were education of bowel habit, abdominal massage, triggered defecation, oral medication and rectal stimulants insertion. Results: The NBD score at the time of discharge decreased significantly in all patients within three months after SCI (p＜0.001). Particularly, AIS A, C, D patients (except for cauda equina syndrome patients) (p＜0.005) showed significant decrease of NBD score. There were no significant difference of NBD score according to age, sex, injured cord level and SCIM (p＞0.05). Conclusion: We could reveal the significant improvement of NBD in patients within three months after SCI during admission. The change was more evident in AIS A, C, D patients.
참고문헌 (19)
- Agachan F, "A constipation scoring system to simplify evaluation and management of constipated patients", Dis Colon Rectum, 39, pp.681~685 (1996)
- Jorge JM, "Etiology and management of fecal incontinence", Dis Colon Rectum, 36, pp.77~97 (1993)
- Knowles CH, "Linear discriminant analysis of symptoms in patients with chronic constipation: validation of a new scoring system (KESS)", Dis Colon Rectum, 43, pp.1419~1426 (2000)
- Rockwood TH, "Fecal incontinence quality of life scale: quality of life instrument for patients with fecal incontinence", Dis Colon Rectum, 43, pp.9~16 (2000)
- Vaizey CJ, "Prospective comparison of faecal incontinence grading systems", Gut, 44, pp.77~80 (1999)
- Krogh K, "Neurogenic bowel dysfunction score", Spinal Cord, 44, pp.625~631 (2006)
- Little JW, "Cauda equina injury: late motor recovery", Arch Phys Med Rehabil, 67, pp.45~47 (1986)
- Lynch AC, "Anorectal physiology following spinal cord injury", Spinal Cord, 38, pp.573~580 (2000)
- Meshkinpour H, "Colonic compliance in patients with spinal cord injury", Arch Phys Med Rehabil, 64, pp.111~112 (1983)
- Banwell JG, "Management of the neurogenic bowel in patients with spinal cord injury", Urol Clin North Am, 20, pp.517~526 (1993)
- Stiens SA, "Neurogenic bowel dysfunction after spinal cord injury: clinical evaluation and rehabilitative management", Arch Phys Med Rehabil, 78, pp.86~102 (1997)
- Catz A, "SCIM- spinal cord independence measure: a new disability scale for patients with spinal cord lesions", Spinal Cord, 35, pp.850~856 (1997)
- Krogh K, "Colorectal function in patients with spinal cord lesions", Dis Colon Rectum, 40, pp.1233~1239 (1997)
- Kim JH, "Chronic gastrointestinal problems and bowel dysfunction in spinal cord injury patients", J Korean Acad Rehabil Med, 21, pp.479~486 (1997)
- Christensen P, "Neurogenic colorectal dysfunction-use of new antegrade and retrograde colonic wash-out methods", Spinal Cord, 38, pp.255~261 (2000)
- Krogh K, "Gastrointestinal and segmental colonic transit times in patients with acute and chronic spinal cord lesions", Spinal Cord, 38, pp.615~621 (2000)
- Stone JM, "Chronic gastrointestinal problems in spinal cord injury patients: a prospective analysis", Am J Gastroenterology, 85, pp.1114~1119 (1990)
- Kirshblum SC, "Bowel care practices in chronic spinal cord injury patients", Arch Phys Med Rehabil, 79, pp.20~23 (1998)
- Na YM, "Complications in spinal cord injured patients", J Korean Acad Rehabil Med, 15, pp.12~21 (1991)