目的 了解西安市功能性便秘(FC)患儿干预现状,比较不同干预策略的疗效,并分析各干预方式的优势与不足,为优化FC患儿管理提供依据。方法 2022年11月—2023年2月,基于罗马Ⅳ诊断标准设计问卷,通过网络平台对西安市1~14岁FC患儿主要照护人开展调查,并按年龄分为＜4岁组和≥4岁组。采用χ2检验或Fisher确切概率法比较不同干预措施的疗效及相关因素。结果 共回收问卷1 988份,剔除无效问卷后有效问卷1 911份(有效回收率96.1%);其中728例(38.10%)未接受任何干预,1 183例(61.90%)接受过医院治疗、药物治疗、饮食调整及物理治疗中的一种或多种干预。两亚组内性别、居住地及是否独生子女与干预效果无关(P＞0.05)。在接受干预的患儿中,饮食调整的采用率及有效率均较高,且干预有效患儿的初次干预时间短于干预无效患儿(P＜0.05)。分策略分析显示:医院治疗疗效与家属配合程度相关(P＜0.05);在≥4岁组中,乳果糖、益生菌、开塞露或通便栓及中药/中成药治疗与较高有效率相关(P＜0.001)。饮食调整中最常用方式为增加蔬菜和水果摄入(＜4岁组92.97%,≥4岁组91.13%)。结论 西安市FC患儿干预策略差异较大,整体疗效不理想。建议强化早期识别与规范化、个体化综合干预,并加强患儿及照护人健康教育以改善预后。
Abstract
Objective To characterize current intervention patterns for functional constipation (FC) in children in Xi′an, and to compare the effectiveness of different intervention strategies, so as to identify their strengths and limitations to inform clinical management. Methods From November 2022 to February 2023, a Rome Ⅳ-based questionnaire was administered via an online platform to primary caregivers of children aged 1 - 14 years with FC in Xi′an.Participants were stratified into <4 years and ≥4 years subgroups.The chi-square test or Fisher′s exact test was used to compare effectiveness across interventions and related factors. Results A total of 1 988 questionnaires were collected, of which 1 911(96.1%) were valid.Of these, 728 children (38.10%) received no intervention, whereas 1 183 (61.90%) received one or more interventions, including hospital-based treatment, pharmacotherapy, dietary adjustment, and physical therapy.Within each age subgroup, sex, residence, and only-child status were not associated with intervention effectiveness (P>0.05).Dietary adjustment was the most frequently adopted strategy and had the highest effectiveness in both subgroups; children with effective outcomeshad shorter initialintervention durationthan those with ineffective outcomes (both P<0.05).Hospital-based treatment effectiveness was associated with family cooperation (P<0.05).In the ≥4-year subgroup, lactulose, probiotics, enema/suppository, and traditional Chinese medicine/Chinese patent medicine were associated with higher effectiveness (P<0.001).Increasing vegetable and fruit intake was the most common dietary approach (92.97% vs.91.13% in the <4-year and ≥4-year subgroups, respectively). Conclusions Intervention strategies for pediatric FC vary substantially in Xi′an, and overall effectiveness remains suboptimal.Early identification and guideline-concordant, individualized multimodal interventions, together with caregiver education, may improve outcomes.
关键词
功能性便秘 /
干预策略 /
依从性 /
预后
Key words
functional constipation /
treatment strategies /
compliance /
prognosis
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基金
陕西省科学技术厅社发重点项目(2022SF-082)
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