肛门生理学检查评估结果与生物反馈治疗盆底功能失调型便秘疗效关系的回顾性分析  

Retrospective Analysis of the Relationship between the Results of Anorectal Physiologic Tests and the Effect on Biofeedback Therapy for Pelvic Floor Dysfunctional Constipation

作　　者：朴镇浩 陆景峰 陈义 茅安炜 刘绍群 苏畅[1] Piao Zhenhao;Lu Jingfeng;Chen Yi;Mao Anwei;Liu Shaoqun;Su Chang(Department of Surgery, Minhang Branch of Zhongshan Hospital, Fudan University, Shanghai, 201199, China)

机构地区：[1]复旦大学附属中山医院闵行分院外科,上海201199

出　　处：《结直肠肛门外科》2018年第3期267-270,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探究肛门生理学检查评估结果对生物反馈治疗盆底功能失调型便秘疗效的预判价值。方法回顾性分析46例接受生物反馈治疗的盆底功能失调型便秘患者临床资料,治疗为每周2次、每次30 min,共5 w。根据其症状改善情况分为显效组及无效组,比较两组一般资料、接受生物反馈治疗前症状评分、球囊排出试验阳性率、肛管直肠压力及容量测定、排粪造影情况。结果 46例患者中显效34例、无效12例,显效率为73.9%。两组年龄、性别、病程、治疗前便秘症状评分差异均无统计学意义(均P>0.05)。治疗前,两组球囊排出试验阳性率差异有统计学意义(P<0.05);无效组排便感觉阈值、排便紧迫感阈值及最大耐受容量均高于显效组(均P<0.05);两组直肠静息压、肛门括约肌最大缩榨压差异均无统计学意义(均P>0.05)。两组静息、提肛、力排相肛直角及肛上距差异均无统计学意义(均P>0.05)。结论对于球囊排出试验阳性及肛门直肠敏感性下降的盆底功能失调型便秘患者而言,应用生物反馈治疗的疗效不理想。Objective To evaluate the predictive capability of anorectal physiologic tests for effectiveness of biofeedback therapy in patients with pelvic floor dysfunctional constipation. Methods The clinical data of 46 patients with pelvic floor dysfunction constipation who received biofeedback therapy were retrospectively analyzed. The treatment was given twice a week, 30 min each time, for 5 weeks.The patients were classified into responding and non-responding group according the improvement of symptoms. The general characteristics, symptom score before treatment, the positive rate of the balloon expulsion test, the measurement of anorectal pressure and volume, and the results of defecography were compared between the two groups. Results Of the 46 patients, 34 responded to biofeedback therapy and 12 did not. The efficacy rate was 73.9%. There was no significant difference in age, gender, duration of disease and symptom score before treatment between the two groups（P〈0.05）. There was a significant difference in the positive rate of balloon expulsion test between the two groups before treatment（P〈0.05）. The rectal volume for first, urgent and maximal sensation was significantly higher in responding group than non-responding group（P〈0.05）. No difference were observed of resting annal pressure or maximal squeezing pressure between the two groups（P〈0.05）. The perineal descent and the anorectal angle of quiescent condition, lift and defecation did not differ between the two groups（P〈0.05）. Conclusion For patients with pelvic floor dysfunctional constipation who have positive balloon expulsion test and reduced sensitivity of anorectum, the effect of biofeedback therapy is unsatisfactory.

关 键 词：盆底功能失调型便秘 生物反馈 疗效 

分 类 号：R442.2[医药卫生—诊断学]