先天性肛门闭锁术后大便失禁的生物反馈治疗  

Biofeedback Therapy of Postoperative Fecal Incontinence in Children with Imperforate Anus

作　　者：袁正伟[1] 吉士俊[1] 王维林[1] 王慧贞[1] 李正[1] 

机构地区：[1]中国医科大学第二临床学院小儿外科,沈阳110003

出　　处：《中华小儿外科杂志》1999年第5期267-271,共5页Chinese Journal of Pediatric Surgery

基　　金：卫生部科学研究基金!资助项目(981191)

摘　　要：目的　探讨先天性肛门闭锁术后大便失禁的治疗方法。方法　利用多种先进的客观检测手段，通过不同侧面对２１ 例肛门闭锁患儿肛门直肠功能进行综合评定，并根据患儿不同的控制机制异常，选择性进行加强肛周肌肉力量、改善直肠感觉阈值等５ 种方法的生物反馈训练。结果　接受生物反馈训练的中低位畸形患儿临床评分由３．７ ±１．０ 提高至５．７ ±０ ．５，而高位畸形由２．３ ±１．０ 提高至４ ．６ ±０ ．５。经过训练之后，代表肛周肌肉力量、直肠功能和直肠肛管综合控制能力的指标均有非常明显的改善，统计学处理差异有显著性意义。结论　针对性的生物反馈训练方法对于治疗肛门闭锁术后大便失禁效果非常显著。Objective The aim of the study is to evaluate the biofeedback therapy in post operative incontinence in children with imperforate anus. Methods Defecograph, anorectal manometry, electromyogram and anal sphincter electrophysiological study were performed on 21 children with imperforate anus. Biofeedback therapy was carried out selectively to strengthen the peri anal muscle tone, improve the rectal sensitivity and shorten the reflex time. Results The clinical scores of the children with low and intermediate types of imperforate anus improved from 3.7 ± 1.0 to 5.7 ± 0.5 whereas those with high type improved from 2.3 ± 1.0 to 4.6 ± 0.5 after biofeedback therapy. The parameters of peri anal muscle tone, rectal function and anorectal control showed significant improvement compared to those without biofeedback therapy or those with home pelvic exercise only. Conclusion The biofeedback therapy is simple and effective in children with imperforate anus suffering from post operative incontinence, resulting in better quality of life.

关 键 词：肛门闭锁 大便失禁 生物反馈疗法 儿童 

分 类 号：R726.571.1[医药卫生—儿科]