肛门功能主观评估工具的研究进展和临床应用现状分析

Research progress and clinical applications of subjective assessment tools for anal function

摘要

肛门功能主观评估工具是了解肛门功能情况、评价疗效的关键依据，对临床决策与科研工作具有重要价值。文章系统梳理了近5年国内外临床研究中应用的三类主观评估工具。描述性评估工具侧重定性记录患者症状；严重程度评估工具着重量化症状的频率与强度，是当前临床功能评估与疗效判断的主要依据；影响评估工具则关注症状对患者生活质量及心理状态的干扰。在此基础上，文章进一步聚焦于严重程度评估工具，比较等级量表与总分量表，详细阐释两者在框架设计与评价维度上的异同，并全面梳理其在结直肠、肛门疾病领域的临床应用现状。通过深入分析，指出现有工具存在的主要问题：部分量表存在地域文化适用性差异、缺乏统一“金标准”，导致研究间异质性较高，且在特定患者群体中的区分能力有限等局限。通过梳理现状与问题，文章为优化主观评估工具的应用策略、提升临床研究的规范性与可比性提供参考，以期推动构建更具文化适配度和临床敏感度的评估体系。

Abstract

Subjective assessment tools for anal function play a crucial role in understanding anal function status and evaluating treatment efficacy, holding significant value for clinical decision-making and scientific research. This review systematically summarizes three types of subjective assessment tools applied in clinical studies over the past five years. Descriptive assessments focus on qualitatively documenting patient symptoms; severity assessments emphasize quantifying the frequency and intensity of symptoms, serving as the primary basis for current clinical functional evaluation and efficacy judgment; impact assessments focus on the interference of symptoms with patients' quality of life and psychological status. Building on this foundation, this review further narrows the focus to severity assessment tools, comparing the similarities and differences between grading scales and summary scales. It elaborates in detail on their distinctions in framework design and evaluation dimensions, and comprehensively reviews their current clinical application in colorectal and anal diseases. Through in-depth analysis, the main limitations of existing tools are identified: some scales exhibit poor cross-cultural adaptability, the lack of a unified "gold standard" leads to high heterogeneity across studies, and certain tools’s discriminative ability are limited in specific patient populations. This review aims to synthesize the current status and existing problems to provide a reference for optimizing the application strategies of subjective assessment tools and enhancing the standardization and comparability of clinical research, ultimately promoting the development of an evaluation system with greater cultural adaptability and clinical sensitivity.

关键词

肛门功能 / 主观评估工具 / 量表 / 结直肠疾病 / 肛门疾病

Key words

Anal function / Subjective assessment tool / Scale / Colorectal diseases / Perianal diseases

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基金资助

国家自然科学基金(82505573)

上海市卫生健康委员会卫生行业临床研究专项(20224Y0161)

上海市“科技创新行动计划”启明星项目(24YF2746200)