Berti Riboli E, Frascio M, Pitto G, Reboa G, Zanolla R
Cattedra di Semeiotica Chirurgica, Universita degli Studi di Genova, Italy.
Arch Phys Med Rehabil. 1988 Jan;69(1):29-31.
Twenty-one subjects suffering daily from fecal incontinence were treated with biofeedback training as a rehabilitative trial. Fifteen of these patients had incontinence following surgical interventions; the other six had senile incontinence. A device was employed to record the pressure existing at the level of the anal canal and to stimulate the rectal ampulla to control the performance of the external anal sphincter and the sensibility of the rectum. Of the 31 treated patients, eighteen (86%) presented good results with satisfactory recovery of anal incontinence, and three subjects (14%) showed unsatisfactory results (more than one episode of incontinence monthly). Although both groups of patients showed improvement in external anal sphincter contraction, the sensibility of the rectum to endoluminal distention improved more in good responders. The employment of biofeedback training to obtain improvement of the threshold of rectal sensibility (minimal volume of endoluminal distention to produce the sensation of imminent defecation and external anal sphincter contraction) has proved useful in the rehabilitation of incontinent patients.
21名每天患有大便失禁的受试者接受了生物反馈训练作为康复试验。这些患者中有15人在手术干预后出现失禁;另外6人患有老年性失禁。使用一种装置记录肛管水平的压力,并刺激直肠壶腹以控制肛门外括约肌的功能和直肠的敏感性。在31名接受治疗的患者中,18名(86%)取得了良好效果,肛门失禁得到了满意的恢复,3名受试者(14%)效果不佳(每月失禁不止一次)。尽管两组患者的肛门外括约肌收缩都有改善,但在反应良好者中,直肠对内腔扩张的敏感性改善得更多。事实证明,采用生物反馈训练来提高直肠敏感性阈值(产生即将排便感觉和肛门外括约肌收缩所需的最小内腔扩张体积)对失禁患者的康复很有用。