凯格尔运动疗法对经肛门内镜显微手术后患者大便失禁发生情况的影响

Effects of Kegel on fecal incontinence in patients with anal endoscopic microsurgery after surgery

目的 探讨凯格尔运动疗法减少经肛门内镜显微手术后患者大便失禁发生率的疗效.方法 采用目的抽样法于2013年10月—2016年6月选择肛门内镜下直肠肿瘤切除术患者60例,按随机数字表法分为对照组和观察组,每组30例,对照组予以常规护理,观察组术前、术后予以凯格尔运动训练,比较两组患者术后大便失禁的发生率、肛门功能优良率及大便失禁持续时间.结果 观察组术后大便失禁发生率为3.3%（1/30）,对照组为23.3%（7/30）,差异无统计学意义（P=0.052）;观察组术后大便失禁持续时间（3.3±0.5）d,对照组（5.3±2.4）d,差异有统计学意义（t=4.468,P〈0.05）.术后第4天,观察组肛门功能评估优良患者28例,对照组22例,差异有统计学意义（Z=-2.020,P〈0.05）.结论 经肛门内镜显微手术患者术前、术后均采用凯格尔运动疗法能有效改善患者肛门功能,缩短大便失禁的持续时间,该方法简单、实用,可推广使用.

ObjectiveTo study the clinical efficacy of Kegel on fecal incontinence in patients with anal endoscopic microsurgery.Methods Totally 60 patients with anal endoscopic microsurgery were randomly selected by purpose sampling method from October 2013 to June 2016,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group. Patients in the control group received routine care,while patients in the observation group was trained by Kegel exercises before and after surgery. Incidence of fecal incontinence,anal function excellent rate and duration of fecal incontinence were observed and compared between two groups.Results The incidence rate of fecal incontinence in the observation group was 3.3%（1/30）,while that of the control group was 23.3% （7/30） （P=0.052）. The postoperative duration of fecal incontinence in the observation group was （3.3±0.5） d,while that of the control group was （5.3±2.4） d （t=4.468,P〈0.05）. Four days after surgery,the number of patients with good anal function in evaluation in the observation was 28,while that of the control group was 22 （Z=-2.020,P〈0.05）. ConclusionsKegel exercises before and after anal endoscopic microsurgery can effectively improve patients＇ anal function and shorten the duration of fecal incontinence. This method is simple,practical and can be widely used.