生物反馈训练可以提高超低位直肠癌内括约肌切除术后的排便功能  

Biofeedback therapy can improve the anal sphincter function in patients with intersphincteric resection for low rectal cancer

作　　者：丛进春[1] 张宏[1] 陈春生[1] 刘恩卿[1] 

机构地区：[1]中国医科大学附属盛京医院肛肠外科,辽宁省沈阳市110004

出　　处：《世界华人消化杂志》2006年第25期2566-2570,共5页World Chinese Journal of Digestology

摘　　要：目的:研究生物反馈技术是否可以提高超低位直肠癌内括约肌切除术后的排便功能．方法:对16例内括约肌切除术后的患者进行生物反馈治疗,分别应用Vaizey和Wexne晰分及直肠肛管向量测压技术来评价生物反馈的效果．结果:生物反馈治疗后Vaizey和Wexner评分显著降低(6．4 vs 8．6,P<0．001;5．4 vs 7．2, P<0．001),最大收缩压(mmHg)及收缩向量容积[cm×(mmHg)2]均显著性提高(205．6±44．5 vs 143．6±46．5,P<0．001:50 664．6±8040．1 vs 13 337．0±7491．1,P<0．000,静息及收缩时的不均衡指数均显著降低(46．8±7．5 vs 58．3±7．4,P<0．001;29．9±6．7 vs 38．3±7．2,P<0．001),直肠肛管反射的阳性率也由训练前的6．3％提高至31.3％．结论:内括约肌切除术后肛管最大压力及向量容积下降,生物反馈技术可以改善部分的排便功能,可以作为提高超低位直肠癌内括约肌切除术后肛门括约肌功能的方法．AIM： To assess the efficacy of biofeedback therapy in the patients received intersphincteric resection for very low rectal cancer. METHODS： From 1999 to 2006, a total of 16 patients underwent intersphincteric resection, and all of them received biofeedback treatments. Therapeutic responses were evaluated with Vaizey, Wexner scoring systems and vectorial manometry. RESULTS： After biofeedback treatments, the Vaizey and Wexner scores were markedly decreased as compared with those before treatments （6.4 vs 8.6, P 〈 0.001; 5.4 vs 7.2, P 〈 0.001）; the maximal contraction pressure （mmHg） and contraction vector volume [cm×（mmHg）^2] were significantly increased （205.6 ± 44,5 vs 143.6 ± 46.5, P 〈 0.001; 50 664.6 ± 8040.1 vs 13 337.0 ± 7491.1, P 〈 0.001）; the asymmetric index as the resting or contracting of sphincter was dramatically down-regulated （46.8 ± 7.5 vs 58.3 ± 7.4, P 〈 0.001; 29.9 ± 6.7 vs 38.3 ± 7.2, P 〈 0.001）; at last, the positive rate of rectoanal reflex was also increased from 6.3% to 31.3%. CONCLUSION： The maximal pressure and vector volume are deficient in patients after intersphincteric resection, while biofeedback therapy can partly improve the anal sphincter function.

关 键 词：超低位直肠癌 内括约肌切除术 生物反馈 

分 类 号：R735.37[医药卫生—肿瘤]