骶神经电刺激治疗非特异性功能性肛门直肠痛的临床效果

Clinical Effect of Sacral Nerve Stimulation in the Treatment of Nonspecific Functional Anorectal Pain

目的 探讨经骶神经电刺激(SNS)治疗非特异性功能性肛门直肠痛(UFAP)的效果。方法 选取2020年1月至2022年1月于焦作市中医院入院治疗的UFAP患者70例,按治疗方式分为治疗组和对照组,其中治疗组35例,对照组35例。对照组患者接受口服氟哌噻吨美利曲辛片及外用硝酸甘油涂抹治疗,治疗组患者经骶3神经孔给予SNS治疗,对比治疗前后对照组与治疗组患者疼痛视觉模拟评分(VAS)、肛门直肠压,健康调查简表评估临床患者生活质量,评估治疗前后两组患者盆底肌电参数变化,比较两组治疗总体有效率。结果 经过治疗后,治疗组和对照组患者VAS评分较治疗前均降低(P<0.05),且治疗组优于对照组(P<0.05);SNS治疗后,相对于对照组,治疗组患者直肠静息压、肛管静息压及肛管最大收缩压降低(P<0.05);治疗组盆底肌平均波幅、中值频率较治疗前下降(P<0.05);两组患者生活质量评分均高于治疗前(P<0.05),且治疗组患者生活质量评分高于对照组(P<0.05)。治疗组总体疗效优于对照组(P<0.05)。结论 SNS可有效缓解UFAP患者疼痛和生活质量,值得临床广泛推广。

Objective To investigate the efficacy of sacral nerve stimulation(SNS) in the treatment of unspecified functional anorectal pain(UFAP).Methods A total of 70 UFAP patients admitted to Jiaozuo Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected and divided into treatment group and control group according to treatment methods, of which 35 were in the treatment group and 35 in the control group. The patients in the control group received oral flupentixol and melitracen tablets and nitroglycerin for external application, and the patients in the treatment group received with SNS through the sacral 3 nerve foramen. The visual analog scale(VAS) and anorectal pressure of patients in the control group and the treatment group were compared before and after treatment. The quality of life of clinical patients was evaluated by the brief form of health survey. The changes of pelvic floor electromyography parameters were evaluated before and after treatment, and the overall effective rate of the two groups were compared.Results After treatment, the VAS scores of both the treatment group and the control group were lower than those before treatment(P<0.05), and the treatment group was better than the control group(P<0.05). Rectal resting pressure, anal canal resting pressure and maximum anal systolic blood pressure were decreased(P<0.05). The average amplitude and median frequency in the treatment group were lower than those before treatment(P<0.05). The quality of life scores of patients in both groups were higher before treatment(P<0.05), and the quality of life score of the patients in the treatment group was higher than that in the control group(P<0.05). The overall effect of the treatment group was better than that of the control group(P<0.05).Conclusion SNS can effectively relieve pain and quality of life in patients with UFAP, and it is worthy of extensive clinical promotion.