功能性肛门直肠痛患者临床特征与硬膜外封闭治疗分析  

Analysis of clinical characteristics of functional anorectal pain patients and epidural closure therapy

作　　者：吴喜华[1] 魏志军[1] 王云 杜明国 廖颖婴[1] 李华娟 张婧茹 黄志芳[2] WU Xihua;WEI Zhijun;WANG Yun;DU Mingguo;LIAO Yingying;LI Huajuan;ZHANG Jingru;HUANG Zhifang(Department of Anorectal Medicine,Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,China;4th College of Clinical Medicine,Traditional Chinese Medicine University Of Guangzhou,Guangzhou 518033,China)

机构地区：[1]深圳市中医院肛肠科,广东深圳518033 [2]广州中医药大学第四临床医学院,广东广州518033

出　　处：《中国医药科学》2018年第4期189-191,208,共4页China Medicine And Pharmacy

摘　　要：目的探究功能性肛门直肠痛患者的临床特征以及硬膜外封闭术的疗效。方法以我院2014年5月~2017年1月收治的100例功能性肛门直肠痛患者作为观察对象,对100例患者的临床资料进行回顾性分析,并分析其临床特征。结合治疗方式将100例患者分为生物反馈组(36例,应用生物反馈治疗)、硬膜外封闭组(64例,应用硬膜外药物注射封闭治疗)。研究对比生物反馈组和硬膜外封闭组患者的疗效、疼痛评分及生活质量评分。结果功能性肛门直肠痛以女性较多见,疼痛常表现为坠胀疼痛,常见于白天,疼痛平均持续时间为(16.46±3.58)min,可向腹部、骶尾部、会阴部、阴道等部位放射;疾病诱发因素和久坐、排便、情绪紧张等因素有关,患者较易合并其他盆底功能障碍性疾病,如便秘、尿失禁。硬膜外封闭组患者总有效率(76.56%)相比生物反馈组(52.78%)明显更高,P<0.05;硬膜外封闭组患者治疗后疼痛评分[(2.98±1.20)分]相比生物反馈组[(4.68±2.01)分]明显更低,且生活质量评分[(107.12±5.10)分]相比生物反馈组[(92.51±7.01)分]明显更高,P<0.05。结论功能性肛门直肠痛以女性较多见,常表现为坠胀疼痛,易合并其他盆底功能障碍性疾病;对患者实施硬膜外封闭术治疗可取得较好的疗效。Objective To explore the clinical features of functional anorectal pain patients and the effect of epidural closure.Methods The clinical data of100patients with functional anorectal pain from May2014to January2017in our hospital were retrospectively analyzed and their clinical features were analyzed.According to the treatment method,100patients were divided into biofeedback group(n=36,using biofeedback therapy),and epidural block group(n=64,using epidural drug injection occlusion treatment).The efficacy,pain score and quality of life score were compared to those in the biofeedback group and the epidural group.Results The functional anorectal pain was more common in women.The pain often showed bulging pain.It was common in the daytime and the average duration of pain was(16.46±3.58)min,which could be radiated to the abdomen,sacrococcygeal,perineal,vagina and other parts;The causes of the disease were associated with sedentary,defecation and emotional stress.Patients were more likely to be associated with other pelvic floor disorders such as constipation urinary incontinence.The total effective rate of epidural block group(76.56%)was significantly higher than that of biofeedback group(52.78%)(P<0.05).The pain score(2.98±1.20)in the epidural block group was significantly lower than that in the biofeedback group[4.68±2.01],and the quality of life score[107.12±5.10]was significantly higher than that in the biofeedback group(92.51±7.01)(P<0.05).Conclusion The functional anorectal pain is more common in women.It often presents with bulging pain and easily combines with other pelvic floor dysfunction diseases.Epidural closure can be effective for patients with functional anorectal pain.

关 键 词：功能性肛门直肠痛 临床特征 硬膜外药物封闭治疗 疼痛 生活质量 

分 类 号：R266[医药卫生—中医外科学]