生物反馈治疗不同亚型功能性排便障碍的临床疗效及影响因素分析  

Clinical efficacy and influencing factors of biofeedback therapy for different subtypes of functional defecation disorders

作　　者：张奕秉 金捷 金健威 袁渝萍 李秦帆 许丽园 ZHANG Yibing;JIN Jie;JIN Jianwei;YUAN Yuping;LI Qinfan;XU Liyuan(Department of Digestion,Wenzhou Central Hospital,the Dingli Clinical Institute of Wenzhou Medical University,Zhejiang,Wenzhou 325000,China)

机构地区：[1]温州市中心医院/温州医科大学定理临床学院消化内科,浙江温州325000

出　　处：《中国现代医生》2022年第28期5-9,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划面上项目(2019KY662);温州市科技局基础公益项目(Y20190161)。

摘　　要：目的 分析生物反馈治疗不同亚型功能性排便障碍的临床疗效及其影响因素。方法 选取2019年1月至2021年6月在温州市中心医院就诊的功能性排便障碍患者98例,将其分为不协调性排便组(66例)和排便推进力不足组(32例)。两组患者均进行生物反馈治疗,比较两组患者的临床疗效,并分析疗效的影响因素。结果 两组患者的治疗总有效率比较差异无统计学意义(χ~2=0.170,P=0.683)。治疗结束时、治疗结束后1个月,两组患者的便秘症状积分、便秘生存质量量表评分均显著低于本组治疗前,肠道满意度评分均显著高于本组治疗前(P<0.05),但两组间上述指标比较差异均无统计学意义(P>0.05)。治疗结束时,排便推进力不足组患者的直肠排便压显著高于治疗前(P<0.05),两组患者的肛管残余压均显著低于本组治疗前(P<0.05)。治疗结束时,排便推进力不足组患者的直肠排便压显著低于不协调性排便组,肛管残余压显著高于不协调性排便组(P<0.05)。多因素二元Logistic回归分析结果显示,受教育年限、肠道满意度评分均是生物反馈治疗功能性排便障碍疗效的独立保护因素,而直肠初始便意感阈值是独立危险因素(P<0.05)。结论 生物反馈治疗不同亚型功能性排便障碍均有效,其疗效与患者的受教育年限、肠道满意度及直肠敏感性等因素相关。Objective To analyze the clinical efficacy and influencing factors of different subtypes of functional defecation disorders in biofeedback therapy. Methods Ninety-eight patients with functional defecation disorders who attended Wenzhou Central Hospital from January 2019 to June 2021 were selected and divided into dyssynergic defecation group(66 cases) and inadequate defecatory propulsion group(32 cases). The two groups of patients were treated with biofeedback therapy. The clinical curative effect of the two groups were compared and the influencing factors of curative effect were analyzed. Results There was no statistically significant difference in the total effective rate of treatment between the two groups(χ~2=0.170, P=0.683). At the end of treatment and one month after the end of treatment, the scores of constipation symptoms and the quality of life scale of constipation in both groups were significantly lower than those of the group before treatment, intestinal satisfaction scores were significantly higher than those of the group before treatment(P<0.05), but there was no significant difference between the two groups(P>0.05). At the end of treatment, the rectal defecation pressure in inadequate defecatory propulsion group was significantly higher than before treatment(P<0.05), the residual pressure of anal canal in both groups was significantly lower than that before treatment(P<0.05). At the end of treatment, the rectal stool pressure in inadequate defecatory propulsion group was significantly lower than that in dyssynergic defecation group, the residual pressure of anal canal was significantly higher than that in dyssynergic defecation group(P<0.05). Multivariate binary Logistic regression analysis showed that years of education and intestinal satisfaction scores were independent protective factors for the efficacy of biofeedback in the treatment of functional defecation disorder, while the threshold of rectal initial bowel sensation was an independent risk factor(P<0.05). Conclusion Biofeedback is effect

关 键 词：功能性排便障碍 生物反馈 疗效 影响因素 

分 类 号：R574.4[医药卫生—消化系统]