电刺激结合生物反馈治疗盆底失迟缓型便秘的临床观察

Clinical observation of electric stimulation combined with biofeedback in the treatment of pelvic floor tachycardia constipation

目的观察生物反馈(触发电刺激+凯格尔训练)与常规治疗手段(饮食、运动、泻药)对盆底失迟缓型便秘疗效的差异。方法回顾性分析2016年9月~2018年8月在我院肛肠科门诊就诊符合盆底失迟缓型的便秘患者130例,其中治疗组(Biofeedback treatment,BFT组)55例,采取生物反馈,对照组(Standard treatment,ST组)75例,采用常规治疗,治疗前后分别评估患者的便秘症状评分及客观检查数据。结果 BFT组WS、ODS评分改善,与对照组比较,差异有统计学意义(P<0.05)。治疗后两组患者PAC-QOL评分均下降,与治疗前比较,差异有统计学意义(P<0.05)。BFT组肛门直肠测压显示患者静息压较治疗前降低(P<0.05)。结论生物反馈在盆底肌失迟缓的患者中能在短期内获得确切的疗效,改善便秘生活质量。常规治疗仅在一定程度上缓解便秘症状,患者的出口梗阻症状依旧存在。

Objective To observe the difference in efficacy between biofeedback (triggering electrical stimulation+Kegel training) and conventional treatment (diet, exercise, laxative) for pelvic floor tachycardia constipation. Methods A total of 130 patients with pelvic floor tachycardia constipation in the anorectal outpatient department from September 2016 to August 2018 in our hospital were retrospective analyzed. Among them, 55 patients received biofeedback in the treatment group (Biofeedback treatment, BFT group). 75 cases in the control group (Standard treatment, ST group) was treated with conventional treatment. The constipation symptom score and objective examination data were evaluated before and after treatment. Results The scores of WS and ODS in the BFT group were improved, and the difference between BFT group and the control group was statistically different(P<0.05). After treatment, the PAC-QOL score of both groups decreased, which was statistically significant compared with that before treatment(P<0.05). Anorectal manometry in the BFT group showed that the resting pressure of the patients was lower than that before treatment(P<0.05). Conclusion Biofeedback can achieve definite curative effect in patients with pelvic floor muscle retardation in short term and improve constipation quality of life. Conventional treatment only relieves the symptoms of constipation to a certain extent, and the patients' exit obstruction symptoms still exist.