生物反馈训练在中低位直肠癌患者肛门直肠功能恢复中的应用

Application of biofeedback exercise among low and middle rectal cancer patients

目的探讨生物反馈训练对中低位直肠癌患者肛门直肠功能恢复的影响。方法采用立意取样法,选取2015年6月—2016年12月中山大学肿瘤防治中心的126例拟接受术前放化疗、直肠前切除术和预防性造口的中低位直肠癌患者,使用SPSS软件产生的随机编码将其随机分为对照1组(空白对照组)、对照2组(盆底肌锻炼组)和干预组(生物反馈训练组),并采用高分辨肛门直肠测压进行16个月,共6次纵向追踪,测量患者直肠初始感觉容量、直肠便意感觉容量等测压指标。结果最终共有109例患者完成研究,其中对照1组38例,对照2组36例,干预组35例。肛管静息压、直肠静息压、肛管最大收缩压、肛管最大收缩时间和肛管高压带5个指标变化的主效应为时间(P<0.05),干预组患者直肠初始容量、直肠便意感觉容量、直肠最大耐受容量和直肠顺应性4个指标高于对照1组(P<0.05);干预组的直肠最大耐受容量和直肠顺应性2个指标高于对照2组(P<0.05)。结论生物反馈训练能改善中低位直肠癌患者的感觉功能指标,促进肠道功能恢复。

Objective To explore the effect of biofeedback exercise on the recovery of rectal function in patients with middle and low rectal cancer. Methods From June 2015 to December 2016, 126 patients with low and middle rectal cancer who were going to undergo preoperative radiotherapy and chemotherapy, anterior rectal resection and preventive stoma were selected by purposive sampling. They were randomly divided into control group 1 (blank control group), control group 2 (pelvic floor muscle exercise group) and invention group (biofeedback exercise group) by random coding generated by SPSS software and were tracked longitudinally for 6 times in 16 months by high resolution anorectal manometry, 11 manometric indices including initial rectal sensory capacity and rectal fecal sensory capacity were measured. Results The study was completed in 109 cases, including 38 cases in control group 1, 35 cases in control group 2, and 35 cases in invention group. The main effects of the changes of five indices, including anal resting pressure, rectal resting pressure, anal maximum systolic pressure, anal maximum systolic time and anal high pressure zone, were time (P<0.05). The four indices of rectal initial capacity, rectal fecal sensory capacity, rectal maximum tolerance capacity and rectal compliance in the invention group were higher than those in the control group 1 (P<0.05);the maximum rectal tolerance capacity and rectal compliance in the invention group were higher than those in the control group 2 (P<0.05). Conclusions The biofeedback exercise could significantly improve the sensory indicators of patients with middle and low rectal cancer and promote recovery.