Kienle Peter, Weitz Jürgen, Koch Moritz, Benner Axel, Herfarth Christian, Schmidt Jan
Department of Surgery, University of Heidelberg, Heidelberg, Germany.
Dig Dis Sci. 2003 Aug;48(8):1607-13. doi: 10.1023/a:1024728210036.
The purpose of this study was to prospectively investigate a consecutive patient series (N = 70) with anal sphincter insufficiency and compare the efficacy of biofeedback and electrostimulation as conservative treatment options. Forty patients were treated by biofeedback training, 30 patients by electrostimulation. Patients were not specifically selected for one or the other treatment. Success was evaluated by vector volume manometry, water infusion test, time until stoma closure and clinical incontinence scores. Resting and squeeze pressure and resting and squeeze vector volume all increased significantly after biofeedback training (P < 0.05 and < 0.001). Resting pressure and squeeze vector volume only were significantly improved by electrostimulation (P < 0.05 and < 0.01). The increase in squeeze vector volume was significantly greater in the biofeedback group (P = 0.03). The estimated median time period from commencement of training until stoma closure was 9 months in the biofeedback versus 21 months in the electrostimulation group. Biofeedback training is probably superior to electrostimulation in the conservative treatment of anal sphincter insufficiency, this needs to be confirmed in a randomized study.
本研究的目的是对一系列连续性的肛门括约肌功能不全患者（N = 70）进行前瞻性调查，并比较生物反馈和电刺激作为保守治疗方案的疗效。40例患者接受生物反馈训练治疗，30例患者接受电刺激治疗。患者并非特意被选择接受某一种治疗。通过向量容积测压法、注水试验、造口闭合所需时间以及临床失禁评分来评估治疗效果。生物反馈训练后，静息压力、收缩压力以及静息向量容积和收缩向量容积均显著增加（P < 0.05和< 0.001）。电刺激仅使静息压力和收缩向量容积显著改善（P < 0.05和< 0.01）。生物反馈组收缩向量容积的增加显著更大（P = 0.03）。从训练开始到造口闭合的估计中位时间，生物反馈组为9个月，而电刺激组为21个月。在肛门括约肌功能不全的保守治疗中，生物反馈训练可能优于电刺激，这需要在一项随机研究中得到证实。
