老年功能性便秘患者盆底表面肌电特征及生物反馈治疗

The clinical application of biological feedback therapyand the characteristics of pelvic floor surface electro-myography in elderly patients with functional constipation

目的探讨老年功能性便秘患者盆底表面肌电的特征,并对生物反馈治疗患者行疗效评价。方法分析258例功能性便秘患者的盆底表面肌电测量五个步骤的12项指标。其中74例功能性便秘患者行生物反馈治疗,老年组50例,非老年组24例,使用便秘患者症状自评量表,两组治疗前后评分及疗效对比,并分析老年组治疗前后盆底表面肌电测量的12项指标。结果盆底表面肌电与非老年组对比:前基线阶段老年组(静息)波幅低于非老年组(P<0.05),变异系数(CV)高于非老年组(P<0.05)。快速收缩阶段收缩反应时间两组无明显差异(P>0.05);最大波幅小于非老年组(P<0.05)。持续收缩阶段老年组收缩波幅小于非老年组(P<0.05),中值频率高于非老年组(P<0.05),变异系数两组无明显差异(P>0.05)。耐久收缩阶段老年组收缩波幅小于非老年组(P<0.05),变异系数及中值频率均高于非老年组(P<0.05)。后基线阶段老年组(静息)波幅小于非老年组(P<0.05),变异系数两组无明显差异(P>0.05)。生物反馈治疗后老年组盆底表面肌电快速收缩阶段最大收缩波幅、持续收缩及耐久收缩阶段收缩波幅均有升高,前基线阶段及耐久收缩阶段变异系数降低,耐久收缩中值频率降低。结论老年组盆底表面肌电特征:前基线波幅、快速收缩最大波幅、持续收缩波幅及耐久收缩波幅较非老年组明显降低;前基线及耐久收缩变异系数升高与非老年组比较有明显差异。生物反馈治疗能提高老年患者盆底肌张力及提高运动协调性。

Objective To evaluate the therapeutic effect of biofeedbackand thecharacteristics of pelvicfloor surface electromyography in elderly patients with functional constipation. Methods Analysis 258 cases offunctional constipation patients with 12 index of five steps of the pelvic floor surface electromyographic. Of these,74 patients（50 older age-group and 24 control group）with functional constipation were treated with biofeedback.Use constipation patient symptomself-assessment scale,before and after treatment,compared two groups with thescord and clinical effect,analysis 12 index of the pelvic floor surface electromyographic in older age-group.Results Compared to control group,the older age-group had a lower amplitude during pre-baseline step,flickstep,tonic step,endurance step and pos-baseline step.The older age-group had a higher CV（coefficient of vari-ance）during pre-baseline step and endurance step,median frequency during tonic step and endurance step. Onsettime during flick step,CV during tonic step andpos-baseline step in the older age-group is as well as controlgroup. The maximal contraction amplitude,continuous contraction and prolonged contraction amplitude were allincreased in the elderly group after biofeedback treatment. The variation coefficient of the prebaseline and theduration of the endurance contraction was decreased. The value frequency of the durable contraction decreases.Conclusion The characteristics of pelvic floor surface electromyography in elderly patients：had a lower ampli-tude duringpre-baseline step,flick step,tonic step,endurance step and pos-baseline step,had a higher CVduring pre-baseline step and endurance step,median frequency during tonic step and endurance step. Biofeedbacktherapy can improve pelvic floor muscle tension and the coordination of sports.