生物反馈联合电刺激对直肠癌保肛术后失禁患者肛门功能的影响  

Effect of biofeedback combined with electrical stimulation on anus functionin patients with anal incontinence after anus preservation for rectal cancer

作　　者：高苗苗 潘晓飞[1] 张艳红 Gao Miaomiao;Pan Xiaofei;Zhang Yanhong(General Surgery,Affiliated Hospital of West Anhui Health Vocational College,Lu'an 237004,China)

机构地区：[1]皖西卫生职业学院附属医院普外科,六安237004

出　　处：《中华保健医学杂志》2022年第3期218-221,共4页Chinese Journal of Health Care and Medicine

基　　金：安徽省自然科学基金项目(1908085MH281)。

摘　　要：目的探究生物反馈联合电刺激对直肠癌保肛术后失禁患者肛门功能的影响。方法前瞻性选取2019年6月~2021年6月皖西卫生职业学院附属医院收治的直肠癌保肛术后排便失禁患者120例,随机数表法分为对照组60例和观察组60例,分别予以常规康复联合电刺激治疗、常规康复联合生物反馈及电刺激治疗。两组均治疗3个月。比较两组治疗前及治疗3个月佛罗里达克利夫兰诊所大便失禁评分(CCF-FIS)、肛门直肠压力[肛管静息压(ARP)、肛管最大收缩压(MSP)、直肠初始感觉容量(FP)和直肠最大耐受容量(MTV)]、盆底表面肌电及治疗结束后3个月随访时复发情况。结果治疗3个月,两组CCF-FIS评分明显低于治疗前,且观察组CCF-FIS评分明显低于对照组(P<0.05)。治疗3个月,两组ARP、MSP、MTV明显高于治疗前,且观察组上述指标均明显高于对照组(P<0.05);治疗3个月,两组FP明显低于治疗前,且观察组FP明显低于对照组(P<0.05)。治疗3个月,两组前基线波幅、持续收缩压变异系数、耐受收缩压变异系数、后基线波幅明显低于治疗前(P<0.05),且观察组上述指标均明显低于对照组(P<0.05);治疗3个月,两组快速收缩压明显高于治疗前,且观察组快速收缩压明显高于对照组(P<0.05)。治疗结束后3个月随访时观察组复发率为8.33%,明显低于对照组的35.00%(P<0.05)。结论生物反馈联合电刺激能有效改善直肠癌保肛术后排便失禁患者肛肠动力学,促进肛门功能恢复。Objective To explore the effect of biofeedback combined with electrical stimulation on anus function in patients with anal incontinence after anus preservation for rectal cancer.Methods 120 patients with defecation incontinence after anus preservation surgery for rectal cancer were prospectively selected from June 2019 to June 2021 in our hospital,the patients were divided into control group(60 cases)and observation group(60 cases)by random number table method,and received conventional rehabilitation combined with electrical stimulation,conventional rehabilitation combined with electrical stimulation and biofeedback therapy respectively.Both groups were treated for 3 months.Comparing the two groups before treatment and treatment for 3 months the Cleveland Clinic Florida Fecal Incontinence Score(CCF-FIS)and the anorectal pressure[(ARP),anal canal resting pressure maximum systolic blood pressure(MSP),rectum initial feeling capacity(FP)and rectal maximum tolerance capacity(MTV)],pelvic floor electrical and treatment methods of relapse after 3 months follow-up.Results At the end of 3 months after treatment,CCF-FIS score in both groups was significantly lower than that before treatment(P<0.05),and CCF-FIS score in observation group was significantly lower than that in control group(P<0.05).At the end of 3 months after treatment,ARP,MSP and MTV in 2 groups were significantly higher than those before treatment(P<0.05),and above indexes in observation group were significantly higher than those in control group(P<0.05);At the end of 3 months after treatment,FP in both groups was significantly lower than before(P<0.05),and FP in observation group was significantly lower than control group(P<0.05).At the end of 3 months after treatment,the amplitude of prebaseline wave,coefficient of variation of sustained systolic blood pressure,coefficient of variation of tolerated systolic blood pressure and amplitude of post-baseline wave in both groups were significantly lower than before treatment(P<0.05),and the above indexes in obse

关 键 词：生物反馈 电刺激 直肠癌 保肛根治术 排便失禁 肛门功能 

分 类 号：R735[医药卫生—肿瘤]