超声引导下肉毒毒素A注射治疗耻骨直肠肌综合征疗效观察  

To Evaluate Ultrasound-guided Botulinum Toxin A Injection Treatment of Puborectal Muscle Syndrome

作　　者：陈建丰[1] 王文琳 刘伟[1] 汪雍容 刘敏[3] 陆伟方 刘春南 Chen Jianfeng;Wang Wenlin;Liu Wei;Wang Yonrong;Liu Min;Lu Weifang;Liu Chunnan(Department of Proctology,The Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015,China;Department of Ultrasound,The Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015,China;Department of Radiology,The Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015,China)

机构地区：[1]杭州师范大学附属医院(杭州中第二人民医院)肛肠外科,杭州市310015 [2]杭州师范大学附属医院(杭州中第二人民医院)超声科,杭州市310015 [3]杭州师范大学附属医院(杭州中第二人民医院)放射科,杭州市310015

出　　处：《中国超声医学杂志》2021年第8期914-917,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声引导下肉毒毒素A注射联合盆底生物反馈治疗耻骨直肠肌综合征(PMS)的疗效。方法 60例PMS患者随机分为治疗组、对照组各30例,对照组予以联合盆底生物反馈治疗,治疗组予以超声引导下肉毒毒素A注射联合盆底生物反馈治疗。结果治疗后肛管静息压、肛管最大收缩压两组均下降,但治疗组下降更加明显(P<0.05)。肛直角角度治疗前后比较,治疗组静息相、力排相均明显变大(P<0.05和P<0.01),对照组力排相有变大(P<0.05),静息相无明显改变(P>0.05);治疗后两组比较,治疗组变大更明显(P<0.05)。治疗组显效率50.00%(15/30)、总有效率83.33%(25/30),均明显高于对照组的16.67%(5/30)、43.33%(13/30)(P<0.05)。结论超声引导下肉毒毒素A注射联合盆底生物反馈治疗PMS,可明显改善患者的肛管静息压、最大收缩压、肛直角异常情况,疗效显著,有临床应用价值。Objective To investigate the clinical efficacy of ultrasound-guided botulinum toxin A injection combined with pelvic floor biofeedback in the treatment of puborectal muscle syndrome(PMS). Methods The 60 patient eligible for PMS were randomly divided into two group, each group included 30 cases. One group was control, which were treated with pelvic floor biofeedback. The other was treatment group, which were treated with ultrasound-guided botulinum toxin A injection combined with pelvic floor biofeedback. Results In three-months follow-up after treatment, ARP and AMCP in two group were reduced apparently as compared with those before treatment, but change was significantly greater in treatment group, the comparison of two group had the statistically significant differences(P<0.05). ARA in rest and forceful defecation in treatment group was significantly increased as compared with those before treatment, indicating the statistically significant differences(P<0.05 and P<0.01), ARA in forceful defecation in control group was significantly increased as compared with those before treatment, indicating the statistically significant differences(P<0.05), however, ARA in rest defecation in control group was not significantly changed as compared with those before treatment, indicating the statistically no significant differences(P>0.05). The comparison of two group had the statistically significant differences in ARA in rest and forceful defecation(P<0.05). After treatment, significant efficiency of the treatment group was 50.00%(15/30), which was significantly higher than 16.67%(5/30) of the control group(P<0.05). The total effective rate of the treatment group was 83.33%(25/30), significantly higher than that of the control group 43.33%(13/30)(P<0.05). Conclusions Botulinum toxin A injection guided by ultrasound combined with pelvic floor biofeedback achieves definite efficacy on PMS and this therapeutic method obviously relieves the symptoms and deserves to be promoted in clinic.

关 键 词：耻骨直肠肌综合征 超声 肉毒毒素A 生物反馈 

分 类 号：R445.1[医药卫生—影像医学与核医学] R574.6[医药卫生—诊断学]