CAJ | 학술논문

目的探讨针对性生物反馈训练方法对合并隐性脊椎裂的功能性便秘(FC)和非潴留性便失禁(NRFI)患儿治疗效果.方法 2003～2006年对34例FC患儿和21例NRFI患儿进行常规保守治疗,在保守治疗无效的患儿中有15例FC患儿和9例NRFI患儿接受针对性生物反馈训练和神经电刺激治疗,并进行客观功能检查,评价治疗效果.结果经过保守治疗有22例(40%)患儿治愈,5例明显好转.保守治疗无效的24例患儿经过针对性生物反馈训练和神经电刺激治疗有19例(79.2%)患儿治愈,其余5例明显好转.保守治疗无效患儿组的平均病程为(3.1±2.9)年,明显长于保守治疗有效的患儿组(2.0±1.2)年(P<0.05),客观检查结果也显示保守治疗无效患儿组的反映肛门直肠功能的指标改变明显严重于保守治疗有效的患儿组,经过针对性生物反馈训练和神经电刺激治疗各项指标均明显恢复(P<0.05).结论针对性生物反馈训练和神经电刺激治疗是治疗合并隐性脊椎裂的FC和NRFI患儿的有效方法.
목적 탐토침대성생물반궤훈련방법대합병은성척추렬적공능성편비(FC)화비저류성편실금(NRFI)환인치료효과.방법 2003～2006년대34례FC환인화21례NRFI환인진행상규보수치료,재보수치료무효적환인중유15례FC환인화9례NRFI환인접수침대성생물반궤훈련화신경전자격치료,병진행객관공능검사,평개치료효과.결과 경과보수치료유22례(40%)환인치유,5례명현호전.보수치료무효적24례환인경과침대성생물반궤훈련화신경전자격치료유19례(79.2%)환인치유,기여5례명현호전.보수치료무효환인조적평균병정위(3.1±2.9)년,명현장우보수치료유효적환인조(2.0±1.2)년(P<0.05),객관검사결과야현시보수치료무효환인조적반영항문직장공능적지표개변명현엄중우보수치료유효적환인조,경과침대성생물반궤훈련화신경전자격치료각항지표균명현회복(P<0.05).결론 침대성생물반궤훈련화신경전자격치료시치료합병은성척추렬적FC화NRFI환인적유효방법.
Objective To evaluate the efficacy of biofeedback and electrical stimulation therapy in children with functional constipation (FC) or non-retentive fecal incontinence (NRFI). Methods Thirty four FC children and twenty one NRFI children underwent conventional treatment, including oral laxatives, high-fibre diet, and toilet training. Among those children who were unresponsive to conventional treatment, 15 FC and 9 NFRI children were treated by biofeedback and electrical stimulation therapy. All children were evaluated with plain X-ray films, neurophysiological study, colonic transit test, EMG and anorectal manometry simultaneously before and after treatment. Results Of the 55 children who received conventional treatment for at least two months, 22 children (40%) recovered according to the clinical recovery standard, and 5 improved significantly. All 24 children who received biofeedback and electrical stimulation therapy reported symptomatic improvements. Nineteen children (79.2%) recovered, and five children had moderate improvement after treatment. Comparing to the children who recovered after the conventional treatment, the children who received the biofeedback and electrical stimulation therapy had longer duration of symptoms (3.1 ± 2.9 years vs. 2.0 ± 1.2 years), and had significantly more deranged anorectal function, especially vector volumes, rectal sensory threshold and latency of pudendo-anal reflex. After biofeedback and electrical stimulation therapy, the anal vector volume during contractions, and the EMG amplitude at rest ＆ during contraction, showed significant improvements (P<0.05). Conclusions The biofeedback with electrical stimulation therapy is suitable for improvement of the clinicat outcome and physiological measurements in FC children or NRFI children.