McKee R F, McEnroe L, Anderson J H, Finlay I G
Department of Coloproctology, Royal Infirmary, Glasgow, UK.
Br J Surg. 1999 Mar;86(3):355-9. doi: 10.1046/j.1365-2168.1999.01047.x.
Biofeedback for outlet obstruction constipation has a varying success rate. The aim of this study was to identify which patients are likely to respond to biofeedback.
Thirty patients with severe outlet obstruction constipation were treated by a specialist nurse using three or four sessions of visual and auditory feedback of anal sphincter pressures. All patients were assessed by evacuating proctography, whole-gut transit studies and anorectal physiology before treatment.
Two patients did not complete the course of biofeedback. Nine patients improved. Before treatment these patients had predominantly normal anorectal physiology and were all able to open the anorectal angle at evacuating proctography. Nineteen patients did not improve, of whom only three had no measured abnormality other than inability to empty the rectum. Ten of these patients had abnormal anorectal physiology which may have been due to previous vaginal delivery.
Biofeedback for outlet obstruction constipation is more likely to be successful in patients without evidence of severe pelvic floor damage.
生物反馈疗法治疗出口梗阻型便秘的成功率各不相同。本研究的目的是确定哪些患者可能对生物反馈疗法有反应。
30例重度出口梗阻型便秘患者由一名专科护士进行治疗，采用三到四次肛门括约肌压力的视觉和听觉反馈。所有患者在治疗前均通过排粪造影、全肠道转运研究和肛肠生理学进行评估。
2例患者未完成生物反馈疗程。9例患者病情改善。治疗前，这些患者的肛肠生理学基本正常，在排粪造影时均能打开肛肠角。19例患者病情未改善，其中只有3例除直肠排空障碍外未检测到异常。这些患者中有10例存在肛肠生理学异常，可能是由于既往阴道分娩所致。
对于没有严重盆底损伤证据的患者，生物反馈疗法治疗出口梗阻型便秘更有可能成功。
