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关键词：肛门闭锁；大便失禁；生物反馈疗法
【摘要】 目的 探讨先天性肛门闭锁术后大便失禁的治疗方法。方法 利用多种先进的客观检测手段，通过不同侧面对21例肛门闭锁患儿肛门直肠功能进行综合评定，并根据患儿不同的控制机制异常，选择性进行加强肛周肌肉力量、改善直肠感觉阈值等5种方法的生物反馈训练。结果 接受生物反馈训练的中低位畸形患儿临床评分由3.7±1.0提高至5.7±0.5，而高位畸形由2.3±1.0提高至4.6±0.5。经过训练之后，代表肛周肌肉力量、直肠功能和直肠肛管综合控制能力的指标均有非常明显的改善，统计学处理差异有显著性意义。结论 针对性的生物反馈训练方法对于治疗肛门闭锁术后大便失禁效果非常显著，对提高患儿生活质量具有重要意义。
Biofeedback Therapyof Postoperative Fecal Incontinence in Children with Imperforate Anus
YUAN Zhengwei, JI Shijun, WANG Weilin, et al.
Department of Pediatric Surgery, The 2nd Clinical College, China Medical University,Shenyang 110003
【Abstract】 Objective Theaim of the study is to evaluate the biofeedback therapy in post-operative incontinence inchildren with imperforate anus. Methods Defecograph, anorectal manometry, electromyogram and anal sphincter electrophysiological study were performed on21 children with imperforate anus. Biofeedback therapy was carried out selectively tostrengthen the peri-anal muscle tone, improve the rectal sensitivity and shorten thereflex time. Results The clinical scores of the children with low andintermediate types of imperforate anus improved from 3.7±1.0 to 5.7±0.5whereas those with high type improved from 2.3±1.0 to 4.6±0.5 afterbiofeedback therapy. The parameters of peri-anal muscle tone, rectal function andanorectal control showed significant improvement compared to those without biofeedbacktherapy or those with home pelvic exercise only. Conclusion Thebiofeedback therapy is simple and effective in children with imperforate anus sufferingfrom post-operative incontinence, resulting in better quality of life.
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