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肛肠检查在预测生物反馈治疗大便失禁效果中的作用。

The role of anorectal investigations in predicting the outcome of biofeedback in the treatment of faecal incontinence.

作者信息

Feretis Michael, Chapman Mark

机构信息

Department of Colorectal Surgery, Heart of England NHS Foundation Trust , Birmingham , UK.

出版信息

Scand J Gastroenterol. 2013 Nov;48(11):1265-71. doi: 10.3109/00365521.2013.837954. Epub 2013 Sep 25.

Abstract

OBJECTIVE

The current literature does not provide unequivocal evidence on prognostic factors of patients' response to biofeedback for management of faecal incontinence. The aim of this study was to identify independent predictors of patient response to biofeedback.

MATERIAL AND METHODS

Baseline demographic characteristics, symptomatology and anorectal investigation reports of 137 patients who completed biofeedback therapy were analysed retrospectively. Short-term response (<3 months) to biofeedback was assessed using subjective criteria (improvement/ no improvement). P Values < 0.05 were considered to be statistically significant.

RESULTS

At univariate analysis, age, duration of symptoms, severity of faecal incontinence, mean maximum squeeze and resting pressure differed significantly (p < 0.05) were associated with patients' response. However, after performing logistic regression analysis age, duration and severity of symptoms were the only variables associated with the outcome (p Values were 0.041, 0.022 and 0.025, respectively).

CONCLUSION

Three independent factors (younger age, shorter duration and lower severity of faecal incontinence) were associated with patient outcome after completing our unit's biofeedback protocol. Anorectal investigations are of questionable value in patient selection for biofeedback therapy.

摘要

目的

目前的文献尚未提供关于粪便失禁患者对生物反馈治疗反应的预后因素的确切证据。本研究的目的是确定患者对生物反馈治疗反应的独立预测因素。

材料与方法

回顾性分析137例完成生物反馈治疗患者的基线人口统计学特征、症状学和肛肠检查报告。使用主观标准(改善/未改善)评估生物反馈的短期反应(<3个月)。P值<0.05被认为具有统计学意义。

结果

单因素分析显示,年龄、症状持续时间、粪便失禁严重程度、平均最大收缩压和静息压存在显著差异(p<0.05),与患者的反应相关。然而,在进行逻辑回归分析后,年龄、症状持续时间和严重程度是与结果相关的唯一变量(p值分别为0.041、0.022和0.025)。

结论

完成本单位生物反馈方案后,三个独立因素(年龄较小、持续时间较短和粪便失禁严重程度较低)与患者预后相关。肛肠检查在生物反馈治疗的患者选择中价值存疑。

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