背景:分娩是增加产科肛门括约肌损伤(OASIS)风险的常见因素。肛门括约肌受损会增加肛门失禁的风险,这对生活质量有削弱的影响。在这组女性中规定了修复后的泻药。然而,关于使用它们的类型或频率没有共识,和现有的指南缺乏一致性和证据来支持这些建议。
目的:目的是回顾和比较国际,关于OASIS术后女性使用泻药的建议的澳大利亚国家和地方管理指南。
方法:对诸如PubMed,Embase,MEDLINE,CINAHL,WebofScience,Scopus和Cochrane在2000年1月至2020年10月之间进行。带有MeSH标题和文本词的全文文章[TW]确定了预防指南,管理和护理绿洲。搜索词包括“产科肛门括约肌损伤”,\'OASIS\',\'会阴撕裂\',\'产后尿失禁\',\'肠道损伤\',\'pleient\',\'泻药使用\'和\'填充剂\'。
结果:包括13个指南。大多数指南都建议使用泻药;然而,使用的泻药类型缺乏一致性,频率,剂量和使用时间。指导方针是基于历史证据,缺乏最近获得的数据。
结论:对于分娩后肛门括约肌损伤的女性,最佳的泻药方案尚无共识。需要进一步的研究来制定基于证据的强有力的临床指南,关于在患有OASIS的女性中使用泻药。
BACKGROUND: Childbirth is a common factor which increases the risk of obstetric anal sphincter injuries (OASIS). Damage to the anal sphincters increases the risk of anal incontinence, which has a debilitating impact on the quality of life. Post-repair laxatives are prescribed in this group of women. However, there is no
consensus regarding the type or frequency with which they are used, and available
guidelines lack consistency and evidence to support the recommendations.
OBJECTIVE: The aim was to review and compare the international, national and local Australian management guidelines for recommendations regarding laxative use in women after OASIS.
METHODS: An online literature search of medical and nursing databases such as PubMed, Embase, MEDLINE, CINAHL, Web of Science, Scopus and Cochrane was performed between January 2000 and October 2020. Full-text articles with MeSH headings and Text Words [TW] identified guidelines in the prevention, management and care of OASIS. The search terms included \'obstetric anal sphincter injury\', \'OASIS\', \'perineal tear\', \'postpartum continence\', \'bowel injury\', \'aperient\', \'laxative use\' and \'bulking agents\'.
RESULTS: Thirteen
guidelines were included. Laxatives were recommended in most guidelines; however, there was a lack of consistency regarding the type of laxative used, frequency, dose and duration of use.
Guidelines were based on historical evidence, with paucity of recently acquired data identified.
CONCLUSIONS: There is no
consensus regarding an optimal laxative regime for women who sustain an anal sphincter injury after childbirth. Further research is required to develop evidence-based robust clinical guidelines regarding laxative use in women who sustain OASIS.