经肛电刺激结合生物反馈在损伤性控便障碍康复治疗中的应用  

Biofeedback therapy combined with electrical stimulation in the treatment of traumatic faecal incontinence

作　　者：孙大庆[1] 孙强三[1] 李殿国[1] 韩克[1] 孙小兵[1] 陈维秀[1] 张丽[1] 

机构地区：[1]山东大学第二医院,济南250033

出　　处：《中华物理医学与康复杂志》2008年第8期551-554,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察经肛电刺激结合生物反馈治疗损伤性控便障碍的疗效。方法对82例损伤性控便障碍患者应用电刺激结合生物反馈进行康复治疗，其中女44例，男38例，平均年龄34．2岁。应用加拿大Laborie公司产UROSTYMTM型生物反馈电刺激冶疗仪，频率为50Hz，强度为0～50mA，行经肛电刺激治疗，并结合肌力、感觉和协调性反馈训练。治疗计划包括3个疗程医院治疗和3个疗程家庭训练。治疗前、后分别进行』临床评分、肛直肠测压及肌电评定。结果治疗前，临床评分为较好者9例，治疗后增至61例；临床评分中等和差劣者所占比例由治疗前的89％下降至26％。治疗后肛直肠收缩压和收缩肌电振幅显著提高（P〈0．05），直肠感觉阈显著降低（P〈0．05），76％的患者肛直肠反射恢复。在2年的随访中，68％的患者治疗效果得以维持。结论经肛电刺激结合生物反馈是治疗损伤性控便障碍的有效方法，值得推广。Objective To observe the effect of biofeedback therapy combined with electrical stimulation in pa- tients with traumatic faecal incontinence. Methods Eighty-two patients with traumatic faecal incontinence were trea- ted once daily with electric stimulation delivered via an intra-anal electrode. They also followed a biofeedback regimen including strengthening, sensory, and coordination biofeedback. The whole program consisted of 3 sessions of supervised treatment in hospital followed by 3 sessions of home therapy （ 10 days per session with an interval of 7days between the sessions）. Clinical scores and anorectal function were assessed before and after the program. Results Before treat- ment, there were 9 patients with good clinical scores, and the general rate of fair and poor clinical scores was 89%. Af- ter therapy, 61 patients had good scores, and the general rate of fair and poor was 26%. Anorectal squeeze pressure and sphincter electromyographic amplitude had improved significantly, the rectal sensory threshold was decreased signif- icantly, and 76% of the patients who had no external anal sphincter reflex recovered. At the two years follow-up, 68% of the patients had maintained the clinical outcomes. Conclusion Biofeedback therapy in conjunction with electrical stimulation has significant therapeutic effects on patients with traumatic faecal incontinence.

关 键 词：电刺激 控便障碍 生物反馈 

分 类 号：R49[医药卫生—康复医学]