中华胃肠外科杂志2024,Vol.27Issue(12) :1238-1242.DOI:10.3760/cma.j.cn441530-20240918-00322

关注肛周良性疾病伴有的躯体症状障碍

Somatic symptoms often comorbid with benign anorectal disorders:a study of their significance

赵治锋 赵青川
中华胃肠外科杂志2024,Vol.27Issue(12) :1238-1242.DOI:10.3760/cma.j.cn441530-20240918-00322

关注肛周良性疾病伴有的躯体症状障碍

Somatic symptoms often comorbid with benign anorectal disorders:a study of their significance

赵治锋 1赵青川1
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作者信息

  • 1. 第四军医大学西京消化病医院消化外科,西安 710032
  • 折叠

摘要

肛周良性疾病是一类既常见又复杂的消化系统疾病,涵盖了肛裂、肛瘘、痔疮、失禁、疼痛以及排便障碍等多种症状,这些疾病既可能源于解剖异常,也可能属于功能性疾病范畴.值得注意的是,部分患者即便在解剖异常得到纠正后,仍可能持续遭受肛周不适、会阴坠胀、排便障碍及腹胀等困扰,这些症状严重时甚至会影响患者的社会功能.以往,结直肠外科医生对躯体症状障碍(SSD)这类疾病关注较少.本文旨在从心身医学的角度,阐述SSD在肛周良性疾病中的具体表现,并呼吁建立生物-社会-心理的医学模式,来提升此类患者的整体康复效果.建议当肛周良性疾病与心理障碍共病时,应先以SSD治疗做铺垫,在心理障碍和SSD得到改善后,再考虑行手术治疗.

Abstract

Benign anorectal diseases represent a prevalent and intricate category of gastrointestinal disorders,encompassing conditions such as anal fissures,fistulas,hemorrhoids,incontinence,pain,and defecation disorders.These conditions include both anatomical abnormalities and functional disorders.Some patients continue to experience discomfort such as perianal discomfort,perineal heaviness,defecation difficulties,and abdominal bloating even after anatomical issues have been addressed,severely impairing social functioning.Generally,colorectal surgeons have paid little attention to somatic symptom disorder(SSD).This article introduced the manifestation of SSD in benign anorectal diseases from a psychosomatic perspective,advocating for the establishment of a biopsychosocial medical model in the diagnosis and treatment of these conditions to enhance patient rehabilitation outcomes.It is recommended that when benign anal diseases coexist with psychological disorders,SSD treatment should be used as a prerequisite.Surgical treatment should be considered only after the improvement of psychological disorders and SSD.

关键词

肛周良性疾病/躯体症状障碍/精神症状/脑肠轴/心理干预

Key words

Benign anorectal disorder/Somatic symptoms disorder/Psychological symptoms/Gut-brain axis/Psychotherapeutic intervention

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出版年

2024
中华胃肠外科杂志
中华医学会,中山大学

中华胃肠外科杂志

CSTPCD北大核心
影响因子:1.764
ISSN:1671-0274
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