分析生物反馈治疗在肛门直肠畸形手术后粪便失禁中的疗效。
Analysis of the efficacy of biofeedback for faecal incontinence after surgery for anorectal malformation.
机构信息
Department of General Surgery, Anhui Provincial Children's Hospital, Hefei, China.
出版信息
Ann Med. 2022 Dec;54(1):2385-2390. doi: 10.1080/07853890.2022.2114607.
OBJECTIVE
To explore the therapeutic effects of biofeedback in the treatment of faecal incontinence (FI) after surgery for anorectal malformation (ARM).
METHODS
Clinical data were collected from paediatric patients for postoperative biofeedback due to FI caused by ARM between May 2017 and November 2021. The data included the duration of symptoms, the integrity of the anal sphincter, anorectal manometry parameters, and FI scores. These patients were divided into the low ARM group (group A) and the high ARM group (group B).
RESULTS
A total of 45 paediatric patients were enrolled in the study. There were 28 cases in group A and 17 cases in group B. The differences in age, gender, and body weight were not statistically significant between the two groups ( > 0.05). The differences in the clinical indicators were also not statistically significant between the two groups at the time of the initial evaluation. The duration of symptoms was 2.21 ± 0.71 years and 4.14 ± 1.89 years in groups A and B. There were 16 cases with an intact anal sphincter in group A and only two cases with an intact anal sphincter in group B. This difference was statistically significant between the two groups ( < .05). The anal resting pressure, initial sensitivity threshold, defaecation sensitivity threshold, defaecation urge threshold, and FI scores were significantly improved in both groups post-treatment compared to pre-treatment ( < .001). Strong impulses improved significantly in group A, while strong impulses did not improve significantly in group B. The multivariate logistic regression analysis with these variables further showed that symptom duration and anal sphincter integrity were the main factors influencing the therapeutic effects of biofeedback.
CONCLUSION
Biofeedback plays a positive role in the treatment of FI in paediatric patients following surgery for ARM. Symptom duration and anal sphincter integrity were found to be the main factors influencing the therapeutic effect of biofeedback.
目的
探讨生物反馈治疗在肛门直肠畸形（ARM）术后粪便失禁（FI）中的疗效。
方法
收集 2017 年 5 月至 2021 年 11 月期间因 ARM 术后 FI 行生物反馈治疗的小儿患者的临床资料。记录患者的症状持续时间、肛门括约肌完整性、肛肠测压参数和 FI 评分等。根据 ARM 分型，分为低位 ARM 组（A 组）和高位 ARM 组（B 组）。
结果
共纳入 45 例患者，A 组 28 例，B 组 17 例。两组患儿年龄、性别、体质量比较差异均无统计学意义（>0.05）。两组初始评估时各项临床指标比较差异均无统计学意义（>0.05）。A 组症状持续时间为 2.21±0.71 年，B 组为 4.14±1.89 年，A 组肛门括约肌完整 16 例，B 组完整 2 例，两组比较差异有统计学意义（<0.05）。两组治疗后肛门静息压、初始感觉阈值、排便感觉阈值、排便急迫阈值、FI 评分均较治疗前明显改善（<0.001）。A 组强收缩力明显改善，B 组强收缩力无明显改善。将上述变量进行多因素 logistic 回归分析，结果显示症状持续时间和肛门括约肌完整性是影响生物反馈疗效的主要因素。
结论
生物反馈治疗在 ARM 术后 FI 患儿中具有积极作用，症状持续时间和肛门括约肌完整性是影响生物反馈疗效的主要因素。
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