生物反馈训练对直肠癌保肛术后低位前切综合征疗效的Meta分析  

The efficacy of biofeedback training on low anterior resection syndrome after anal preservation for rectal cancer:a Meta-analysis

作　　者：王小英[1] 王佳明 WANG Xiaoying;WANG Jiaming(Gansu Provincial Hospital,Gansu 730000 China)

机构地区：[1]甘肃省人民医院,甘肃730000

出　　处：《循证护理》2024年第12期2099-2105,共7页Chinese Evidence-Based Nursing

基　　金：甘肃省卫生健康行业科研计划项目,编号:GSWSHL2021-013。

摘　　要：目的:系统评价生物反馈训练对直肠癌术后低位前切综合征(LARS)的疗效。方法:计算机检索PubMed、EMbase、Web of Science、MedLine、中国知网、中国生物医学文献数据库、万方数据库和维普数据库中有关生物反馈训练治疗直肠癌术后低位前切综合征疗效的相关研究,检索时限从建库至2023年6月30日,采用RevMan 5.3进行Meta分析。结果:共纳入13项研究,涉及1 001例病人。Meta分析结果显示,生物反馈训练能够减少病人术后排便次数[MD=-3.50,95%CI(-4.05,-2.95),P<0.000 01]及降低LARS发生率[OR=0.34,95%CI(0.18,0.64),P=0.000 9],提高病人术后肛管静息压[MD=8.28,95%CI(4.28,12.29),P<0.000 1]、术后最大收缩压[MD=20.20,95%CI(8.09,32.30),P=0.001]和最大耐受容量[MD=19.25,95%CI(7.91,30.60),P=0.000 9],降低术后Wexner评分[MD=-3.38,95%CI(-5.41,-1.35),P=0.001]和徐氏排便评分[MD=1.97,95%CI(1.51,2.43),P<0.000 01],差异均有统计学意义。结论:现有证据表明,生物反馈训练能降低病人排便次数,降低LARS发生率,能改善病人术后肛肠动力学客观指标及术后主观感受评分,对治疗低位前切综合征具有重大意义。Objective:Systematic evaluation of the efficacy of biofeedback training in postoperative low anterior resection syndrome in rectal cancer.Methods:A computerized search of PubMed,EMbase,Web of Science,MedLine,CNKI,CBM,WanFang Database,and VIP was conducted for studies related to the efficacy of biofeedback training in the treatment of postoperative anterior resection syndrome in rectal cancer,with a time frame of the search from the establishment of the database to June 30,2023,and RevMan 5.3 was used for the Meta-analysis.Results:A total of 13 articles involving 1 001 patients were included,and the results of Meta-analysis showed that biofeedback training was able to reduce the number of postoperative bowel movements(MD=-3.50,95%CI-4.05--2.95,P<0.000 01) and the incidence of LARS(OR=0.34,95%CI 0.18-0.64,P=0.000 9),increase the postoperative anal canal rest pressure(MD=8.28,95%CI 4.28-12.29,P<0.000 1),postoperative maximal systolic blood pressure(MD=20.20,95%CI 8.09-32.30,P=0.001)and maximum tolerance capacity(MD=19.25,95%CI 7.91-30.60,P=0.000 9),and lowered patients′ postoperative Wexner′s score(MD=-3.38,95%CI-5.41--1.35,P=0.001) and defecation score(MD = 1.97,95%CI 1.51-2.43,P< 0.000 01),and the differences were statistically significant.Conclusion:Available evidence suggests that biofeedback training can reduce the number of bowel movements,decrease the incidence of LARS,and improve the objective indicators of anorectal dynamics,and postoperative subjective feeling scores of the patients,which is of great significance in the treatment of low anterior resection syndrome.

关 键 词：生物反馈训练 直肠癌 低位前切综合征 META分析 循证护理 

分 类 号：R473.73[医药卫生—护理学]