反射诱导训练与小儿大便失禁的康复

Rehabilitation of Fecal Incontinence in Children

为了提高小儿先天性肛门直肠畸形术后或其他外伤所致大便失禁的治疗效果，对１８例２～１５岁进行过括约肌重建术的患儿，行加强盆底肌的协同共济肌与毗邻肌肌力的诱导训练和反射诱导恢复排便控制反射的康复治疗。随访１～９年，结果能坚持康复训练组７例，均于半年内达到社会可接受的排便控制，而不能配合训练组１１例中，仅４例在１年内恢复排便控制。反射诱导训练比生物反馈训练更经济、更易学，适合我国国情，可缩短康复时间，提高患儿日后的生活质量。

In children with fecal incontinence following congenital anorectal malformation or trauma,the rehabilitation training will achieve a fecal continence earlier. It is emphasized that the training should include all muscle activities of coaborators and adjacencies,and the introduction of bowel reflex.Eighteen children with incontinence underwent sphincter reconstruction and followed up for 1-9 years. Seven patients who had regular postoperative training,obtained an acceptable bowel movement by 6 months. In the other 11 who neglected training,4 obtained an acceptable continence in one year. A recommended training program includes a bed-lying physical exercises as following:raising the extended legs,opisthotonoid elevating the hips,sitting-ups,clapping knees and buttocks,besides,an additional digital anal stimulation and rectal balloon stimulation to induce bowel reflex. This program is easier to be popularized in China at the present time,it is much less expensive than modern biofeed back therapy.