骶神经电刺激治疗盆底痉挛综合征  

The effect of sacral nerve stimulation （SNS） on spastic pelvic floor syndrome

作　　者：王志民[1] 辛学知[1] 段明明[1] 林鸿[1] 

机构地区：[1]山东大学附属千佛山医院肛肠外科,济南250014

出　　处：《中华普通外科杂志》2012年第11期900-902,共3页Chinese Journal of General Surgery

基　　金：山东省科技发展计划基金资助项目（2011YD18090）

摘　　要：目的 观察骶神经电刺激（sacral nerve stimulation,SNS）治疗盆底痉挛综合征（spastic pelvic floor syndrome,SPFS）的疗效.方法 选取2011年3-12月接受SNS治疗SPFS的患者36例,观察SNS治疗的临床效果、肛门测压及排粪造影变化.结果 经一个疗程的SNS治疗后,3个月时随访,治愈12例,好转22例,无效2例,总有效率为94.4％.治疗后患者排便不尽感、排便困难、肛门疼痛、肛门梗阻感较治疗前明显减轻,差异有统计学意义（P＜0.01）；治疗后患者直肠肛门反射（ rectal anal reflex,RAR）阈值容积上升,肛管最大收缩压（anal maximum contraction pressure,AMCP）、肛管静息压（anal rest perssure,ARP）显著降低,与治疗前相比差异有统计学意义（P＜0.01）；肛管最长收缩时间（anal longest contraction time,ALCT）、直肠静息压（rectal rest pressure,RRP）与治疗前相比,差异无统计学意义（P＞0.05）；治疗后患者用力排便时肛直角增大,耻骨直肠肌压迹较治疗前明显减轻,差异有统计学意义（P＜0.01）.结论 SNS治疗SPFS的效果确切,症状改善明显,是值得临床推广的微创治疗方法.Objective To evaluate sacral nerve stimulation （SNS） in the treatment of spastic pelvic floor syndrome （SPFS）.Method In this study,36 patients of spastic pelvic floor syndrome who received SNS treatment from 2011.3 to 2011.12,were reviewed in terms of clinical curative effect,changes of anal pressure and defecography.Result After a course of SNS treatment,patients were followed up for 3 months,12 cases were cured,22 cases improved and 2 cases were ineffective,the total effective rate was 94.4%.The symptoms such as endless defecate feeling,difficulty in defecation,anal pain and anal obstruction feeling improved significantly （P 〈0.01 ）.After the therapy,rectal anal reflex（ RAR）threshold value volume rose,anal maximum contraction pressure （AMCP）,anal rest perssure （ARP） decreased （P 〈 0.01 ）.While the anal longest contraction time （ALCT）and rectal rest pressure （RRP） did not change significantly （P 〉 0.05 ）.After treatment,when patient defecate the anorectal angle （ARA） increases,the puborectal muscle spasm notch （PMSN）attenuates （P 〈 0.01 ）.Conclusions SNS is effective and minimally invasive in treating spastic pelvic floor syndrome.

关 键 词：电刺激疗法 便秘 盆底痉挛综合征 

分 类 号：R657.1[医药卫生—外科学]