中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2010年
8期
580-582
,共3页
杜鹏%子树明%翁子毅%陈卫%陈燕%崔龙
杜鵬%子樹明%翁子毅%陳衛%陳燕%崔龍
두붕%자수명%옹자의%진위%진연%최룡
直肠肿瘤%生物反馈%保肛术%大便失禁
直腸腫瘤%生物反饋%保肛術%大便失禁
직장종류%생물반궤%보항술%대편실금
Rectal neoplasms%Biofeedback%Restorative resection%Fecal incontinence
目的 探讨生物反馈治疗对于中低位直肠癌术后排粪功能障碍的疗效.方法 对24例中低位直肠癌术后排粪功能障碍的患者予以生物反馈治疗(治疗组),进行治疗前后直肠肛管压力检测及肛管功能评分(Vaizey评分和Wexner评分),并与同期住院的18例无排粪功能障碍患者(对照组)进行比较.结果 治疗组患者术后肛管静息压(27.8+9.0)mm Hg,最大收缩压(118.3±42.9)mm Hg,直肠初始感觉容量(19.0±6.1)ml,直肠最大耐受容量(97.5±52.8)ml;显著低于对照组的(55.7±8.5)mm Hg、(233.2±31.7)mm Hg、(25.8±4.4)ml和(229.3±39.7)ml(均P<0.01 ).经生物反馈训练后,肛管静息压、最大收缩压和直肠最大耐受容量显著性提高,分别为(47.9±9.3)mm Hg、(193.2±38.2)mm Hg和(189.1±39.0)ml(P<0.01),而直肠初始感觉容量未见明显增加[(21.5±4.8)ml,P=0.101].治疗组患者生物反馈治疗前的Vaizey评分和Wexner评分为12.9±2.8和10.1±2.6;治疗后显著降低,分别为10.5±2.3和7.5±2.5(P<0.01).结论 生物反馈治疗方法可以改善直肠癌保肛手术后肛门功能障碍.
目的 探討生物反饋治療對于中低位直腸癌術後排糞功能障礙的療效.方法 對24例中低位直腸癌術後排糞功能障礙的患者予以生物反饋治療(治療組),進行治療前後直腸肛管壓力檢測及肛管功能評分(Vaizey評分和Wexner評分),併與同期住院的18例無排糞功能障礙患者(對照組)進行比較.結果 治療組患者術後肛管靜息壓(27.8+9.0)mm Hg,最大收縮壓(118.3±42.9)mm Hg,直腸初始感覺容量(19.0±6.1)ml,直腸最大耐受容量(97.5±52.8)ml;顯著低于對照組的(55.7±8.5)mm Hg、(233.2±31.7)mm Hg、(25.8±4.4)ml和(229.3±39.7)ml(均P<0.01 ).經生物反饋訓練後,肛管靜息壓、最大收縮壓和直腸最大耐受容量顯著性提高,分彆為(47.9±9.3)mm Hg、(193.2±38.2)mm Hg和(189.1±39.0)ml(P<0.01),而直腸初始感覺容量未見明顯增加[(21.5±4.8)ml,P=0.101].治療組患者生物反饋治療前的Vaizey評分和Wexner評分為12.9±2.8和10.1±2.6;治療後顯著降低,分彆為10.5±2.3和7.5±2.5(P<0.01).結論 生物反饋治療方法可以改善直腸癌保肛手術後肛門功能障礙.
목적 탐토생물반궤치료대우중저위직장암술후배분공능장애적료효.방법 대24례중저위직장암술후배분공능장애적환자여이생물반궤치료(치료조),진행치료전후직장항관압력검측급항관공능평분(Vaizey평분화Wexner평분),병여동기주원적18례무배분공능장애환자(대조조)진행비교.결과 치료조환자술후항관정식압(27.8+9.0)mm Hg,최대수축압(118.3±42.9)mm Hg,직장초시감각용량(19.0±6.1)ml,직장최대내수용량(97.5±52.8)ml;현저저우대조조적(55.7±8.5)mm Hg、(233.2±31.7)mm Hg、(25.8±4.4)ml화(229.3±39.7)ml(균P<0.01 ).경생물반궤훈련후,항관정식압、최대수축압화직장최대내수용량현저성제고,분별위(47.9±9.3)mm Hg、(193.2±38.2)mm Hg화(189.1±39.0)ml(P<0.01),이직장초시감각용량미견명현증가[(21.5±4.8)ml,P=0.101].치료조환자생물반궤치료전적Vaizey평분화Wexner평분위12.9±2.8화10.1±2.6;치료후현저강저,분별위10.5±2.3화7.5±2.5(P<0.01).결론 생물반궤치료방법가이개선직장암보항수술후항문공능장애.
Objective To investigate the efficacy of biofeedback therapy for fecal incontinence in patients with mid or low rectal cancer. Methods Twenty-four patients with mid or low rectal cancer received biofeedback treatments after restorative resection and therapeutic efficacy was evaluated using anorectal manometry and Vaizey and Wexner scoring systems. Eighteen inpatients without defecating difficulties were selected as control group. Results The parameters of anorectal manometry in patients with rectal cancer were significantly lower than those in the control group(P<0.01).Mter biofeedback therapy,the maximum squeeze pressure,resting pressure and maximum tolerated volume were significantly increased,from(118.3±42.9)mm Hg to(193.2±38.2)mm Hg,(27.8±9.0)mm Hg to (47.9±9.3)mm Hg,(97.5±52.8)ml to(189.1±39.0)ml,respectively(all P<0.01),while no significant difference in sensory threshold was observed(P=0.101).Post-treatment Vaizey(10.5±2.3 vs 12.9±2.8) and Wexner (7.5±2.5 vs 10.1±2.6)scores were significantly decreased compared with those before biofeedback(P<0.01).Conclusion Biofeedback therapy can impmve the anal function in patients with rectal cancer after restorative resection.
