척수 손상 환자에서 교감신경계 및 Oxybutynin이 대장 통과 시간에 미치는 영향

Abstract

Objective: The aims of this study is to determine the influence of the imbalance between sympathetic and parasympathetic nervous input to colon transit control in spinal cord injured patients and the effect of the anticholinergic medication for neurogenic bladder on colon transit time.

Method: Eighty-six patients with cervical and thoracic cord injury were enrolled. The colon transit time (CTT) according to the severity and lesion of injury and also the administration routes of oxybutynin were compared by independent t-test.

Results: Total CTT was 56.7 hours, with right CTT 16.9 hours, left CTT 21.3 hours and rectosigmoid CTT 18.5 hours. The rectosigmoid CTT of the patients with the lesion at T6 or below were prolonged than that of the patients with the lesion above T6 (p＜0.05). According to administration route of oxybutynin, instillation group showed more shortened rectosigmoid CTT than oral route group (p＜0.05).

Conclusion: The imbalance between parasympathetic and sympathetic outflow from the spinal cord has play an important role in colon transit control of spinal cord injured patients. The management of neurogenic bowel and bladder considering colon transit time is needed for the effective management of spinal cord injured patients.