慢性功能性便秘肛直肠压力检测及EMG生物反馈训练疗效的研究  

Study on the Anorectal manometry and effect of Biofeedback Training by EMG on Patients with Chronic functional Constipation

作　　者：杨柳明[1] 林济宝 梁绛菱[1] 钟文英[1] 林红[1] 陈荣伟[1] 谢俊芳[1] 

机构地区：[1]广东省廉江市人民医院消化科,524400

出　　处：《现代消化及介入诊疗》2001年第3期15-19,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨慢性功能性便秘(CFC)患者肛直肠压力及肌电(EMG)活动特点,同时观察生物反馈训练系统对 CFC 患者的疗效及对上述指标的影响。方法用 BIOLAB 动力学参数监测系统(液态式),多道胃肠功能检查仪对144例 CFC 患者检测,并用 OrionPC/12mEMG 生物反馈治疗仪进行肌电评估和训练,20例健康者作对照。结果与健康对照组相比,CFC 患者肛管静息压稍下降(P>0.01)、最大缩榨压明显降低(P<0.01),直肠感知阈和最大耐受量均显著增高(P<0.01);EMG 评估 CFC 患者盆底肌与腹前斜肌有矛盾运动100%,其运动幅值盆底肌静息状态下升高(P<0.01)和腹前斜肌降低(P<0.01);OrionPC/12mEMG 生物反馈训练治疗后可显著改善 CFC 患者上述异常改变(P<0.01),生物反馈治疗 CFC 患者临床症状改善,总有效率为84.03%,增加疗程的频次、缩短治疗间隔以及辅助家庭训练等可以提高疗效和降低复发率(P<0.01)。结论CFC 患者存在肛门直肠动力、感知觉及肌电活动异常,OrionPC/12mEMG 生物反馈系统可以改善上述异常表现,对84.03%的 CFC 患者具有良好的疗效,较长时间的强化训练可望提高近期疗效,辅助家庭训练可降低复发率。Objective: Probe into the characteristic of anorectal pressure and the EMG activity and effect of Biofeedback training system on patient with chronic functional constipation(CFC)and impact on above-mentioned indexes. Methods: Anorectal manometry was carried out in 144 CFC of patients by Monitor system(liquid state type)with BIOLAB dynamics parameter method and appearance many dishes of intestines and stomach function before and after the Biofeedback training. 20 examples the healthy ones do contrast. Result compared with contrast group of the health, CFC patients showed slightly lower anal quiesent pressure(P>0.01), lower anorectal sphincteric squeezing pressure(P<0.01),higher rectal defection volume thresholds and higher rectal maximum talerable volume thresholds(P<0. 01);EMG assesses 100% of the contradictory sport in between the pelvic floor muscle and belly oblique muscle, sport extent of the pelvic floor muscle rise under quiesent states (P<0.01), belly oblique muscle reduces(P<0.01); All the abnormalities significantly improved with OrionPC/12m EMG Biofeedback training therapy(P<0. 01). After Biofeedback training therapy, CFC patient's clinical symptom to improve, it is 84. 03% that always efficient; To increase the frequently time of course of treatment and shortenning the treat interval and assisting train that can raise curative effect and reducing recuring rate (P<0.01).Conclusion CFC patients have bath abnormal anorectal pressure and sensation threshold and anus electric unusual activities, Biofeedback training therapy can improve above-mentioned indexes and is effective in 84. 03% the cases, The relatively long-time intensive training can be expected to improve the curative effect of the near future, assisting the family can reduce the recuring rate to train.

关 键 词：患者 EMG 生物反馈训练 直肠 慢性功能性便秘 疗效 复发率 生物反馈治疗 CFC 肌电 

分 类 号：R574.62[医药卫生—消化系统] R681.53[医药卫生—内科学]