摘要
In recent years, professional societies in China including the Chinese Medical Doctor Association Anorectal Branch have issued many clinical practice guidelines and expert consensus on constipation, which played a positive role in the standardization of diagnosis and surgical treatment of chronic constipation in China. However, the diagnosis and treatment of outlet obstructive constipation (OOC) remain controversial. OOC, the most common subtype of functional constipation, is featured by various clinical symptoms, complex pelvic floor anatomy, functional and psychological aspects. We need a gold standard supported by high-level clinical research evidence. To standardize the diagnosis and treatment process of OOC in China, Chinese Medical Doctor Association Anorectal Branch and its Clinical Guidelines Committee, and jointly sponsored by Professional Committee on Anorectal Diseases of Chinese Society of Integrated Traditional Chinese and Western Medicine, Anorectal Disease Committee of Chinese Medical Women's Association and Chinese Constipation Medical Association, and the Chinese Journal of Gastrointestinal Surgery organized and summoned a Chinese expert taskforce to focus on OOC diagnosis, classification, examination, evaluation, and various treatments (e.g. diet modification, medication, biofeedback therapy, pelvic floor function training, psychological intervention, traditional Chinese medicine and surgical treatment). Based on the latest relevant evidence in China and abroad and experts' clinical experience, the taskforce produced the " Chinese expert consensus on the diagnosis and treatment of outlet obstructive constipation (2022 edition)" after rounds of discussion and revision. The aim is to help anorectal surgeons make clinical decisions, standardize the process of diagnosis and treatment, reduce complications and improve clinical efficacy in OOC.近年来,中国医师协会肛肠医师分会等我国多个学会陆续发布了便秘相关的多个诊治指南及专家共识,对我国慢性便秘外科诊治的规范化开展起到了积极的作用。但是作为功能性便秘最常见亚型的出口梗阻型便秘(OOC),由于其临床症状多样、盆底解剖复杂,还涉及到功能和心理等多个方面,其诊断和治疗仍然是一个非常有争议的问题,尚缺乏金标准与高级别的临床研究证据。为了规范我国OOC的诊治流程,提高临床疗效和减少治疗并发症,由中国医师协会肛肠医师分会及其临床指南工作委员会牵头,中国中西医结合学会大肠肛门病专业委员会、中国女医师协会肛肠专业委员会、中华便秘医学会等共同发起,由《中华胃肠外科杂志》组织召集国内本研究领域的专家组成工作团队,针对OOC的诊断、OOC的分类和检查及评估、治疗包括培养良好的饮食生活习惯、药物治疗、生物反馈治疗、盆底功能训练、心理干预、中医中药治疗和外科治疗等,在检索相关文献的基础上,结合国内外最新循证医学证据和临床经验,经过多次讨论修改,并对相关内容进行投票表决,达成了《出口梗阻型便秘诊治中国专家共识(2022版)》,旨在帮助肛肠外科医生做出临床决策,规范诊疗流程,减少并发症,提高临床疗效。.