生物反馈盆底肌肉锻炼在产妇产后盆底功能康复治疗中的应用

目的探讨生物反馈盆底肌肉锻炼在产妇产后盆底功能康复治疗中的应用效果。方法选取2017-02—2018-02间郑州大学第一附属医院收治的100例分娩产妇,根据产后盆底功能康复治疗方法的差异分为2组,每组50例。对照组产妇给予常规盆底肌肉锻炼,观察组产妇在对照组基础上应用生物反馈仪进行康复治疗。结果盆底功能康复治疗2个月,产后102 d时,观察组产妇盆底肌力分级明显高于对照组,盆底肌最大肌电压及盆底肌持续收缩60 s的肌电压均明显高于对照组,产妇的尿道膀胱后角和尿道膀胱连接部的移动度小于对照组,膀胱颈到耻骨联合下缘距离高于对照组。以上指标的差异均有统计学意义(P0.05)。结论对产妇使用生物反馈治疗仪康复治疗,有助于促进产妇产后盆底功能恢复,预防盆底功能障碍性疾病的发生,可显著改善产妇产后的生活质量。     

盆底肌功能紊乱的生物反馈治疗

为探讨盆底肌功能紊乱疾病及其生物反馈治疗的意义,对33例患者生物反馈治疗加自身功能锻炼提肛运动1个月进行分析。结果显示,16例恢复正常,8例有间断出现紊乱的患者,通过再次治疗功能恢复正常,7例反复出现紊乱,2例需进行长期治疗。结果表明,生物反馈疗法加自身功能锻炼提肛运动可使盆底肌功能紊乱基本得到恢复。     

生物反馈训练治疗出口梗阻型便秘72例

2009～2011年,我们对72例出口梗阻型便秘患者进行生物反馈训练治疗,取得满意疗效,总结报道如下。     

生物反馈治疗慢传输型便秘23例疗效观察

为观察生物反馈治疗慢传输型便秘（sTc）的临床疗效,回顾性分析采用生物反馈治疗的23例不同程度慢传输型便秘患者资料。结果显示,23例STC患者经生物反馈治疗后均有不同程度症状改善,其中显效6例,有效9例,无效8例,总有效率65．2％。结果表明,生物反馈治疗慢传输型便秘有较好的疗效,可减轻腹胀、排便困难、便意减少等症状,无任何不良反应及并发症。     

生物反馈疗法治疗出口梗阻型便秘38例临床分析

为探讨生物反馈疗法对出口梗阻型便秘（OOC）患者的临床疗效,对符合罗马Ⅲ标准并经直肠肛管压力测定、表面肌电评估诊断为以盆底功能紊乱为主要特征的38例OOC患者进行生物反馈治疗。结果显示,38例患者经生物反馈治疗后,临床症状和肛管肌电图均得到极大改善,有效率分别为84．21％（32／38）和71．05％（27／38）;且生物反馈治疗疗效与患者年龄及性别呈直线相关性（P〈0．05）。结果表明,生物反馈疗法是治疗OOC的有效方法。     

针灸联合盆底生物反馈对脑卒中后便秘患者康复质量的影响

为分析针灸联合盆底生物反馈对脑卒中后便秘患者康复质量的影响,将脑卒中后便秘患者80例随机分为对照组和联合组,每组40例.对照组患者采用生物反馈治疗,联合组患者采用针灸联合盆底生物反馈治疗,比较2组患者临床疗效、不良反应、中医症候积分及生活质量.结果显示,联合组患者总有效率明显高于对照组(P<0.05),联合组患者不良反...     

盆底表面肌电生物反馈配合心理认知疗法治疗功能性便秘疗效观察

为观察盆底表面肌电生物反馈配合心理认知疗法治疗功能性便秘的临床疗效,将符合功能性便秘诊断标准的30例患者在治疗前及治疗2个疗程后评定症状及SCL-90量表中的积分,进行对比分析。结果显示,功能性便秘患者治疗前后排便费力、排便不尽感、排便时间及SCL-90量表中抑郁、强迫及偏执因子的积分均有不同程度的改善。结果表明,盆底表面肌电生物反馈配合心理认知治疗功能性便秘疗效肯定。     

生物反馈疗法治疗出口梗阻型便秘的临床观察

为观察生物反馈疗法治疗出口梗阻型便秘的疗效,对36例出口梗阻型便秘患者采用生物反馈疗法治疗,比较治疗前后便秘症状及肛门直肠压力的变化。结果显示,经生物反馈疗法治疗后：（1）治疗患者便秘临床症状的有效率为77．8％,治疗后大便性状、排便次数、伴随症状等有所改善;（2）肛管静息压、直肠感觉阈值、直肠最大耐受量、肛管直肠反射阈值降低（P〈0．05）。结果表明,生物反馈疗法治疗出口梗阻型便秘效果满意,是一种无创、简单有效的治疗手段。     

四物汤加味内服联合生物反馈疗法治疗女性盆底功能障碍性便秘的临床研究

目的:探讨四物汤加味内服联合生物反馈疗法治疗盆底功能障碍性便秘的临床疗效。方法:选择2020年1月至2022年4月我院诊治的80例女性盆底功能障碍性便秘患者作为研究对象,根据随机数字表法分为观察组和对照组,每组40例,对照组接受生物反馈疗法治疗,观察组接受四物汤加味联合生物反馈疗法治疗。比较2组临床疗效、治疗前后Bristol粪便性状、便秘患者症状自评量表(PAC-SYM)评分及盆底肌力。结果:观察组治疗总有效率(95.00%)明显高于对照组(77.50%),P<0.05。2组治疗前Bristol粪便性状评分、PAC-SYM评分及盆底肌力评分均无明显差异,P>0.05。治疗后,治疗2周、4周、6周及治疗后1个月和3个月时,2组患者Bristol粪便性状评分均明显升高,PAC-SYM评分均明显降低(P<0.05),其中观察组Bristol粪便性状评分更高(P<0.05),PAC-SYM评分更低(P<0.05)。治疗后1个月、3个月患者盆底肌力均较治疗前明显改善,其中观察组盆底肌力评分更高(P<0.05)。结论:四物汤加味内服联合生物反馈疗法治疗盆底功能...     

功能性便秘患儿肛门内括约肌检测的临床意义

目的探讨功能性便秘患儿肛门内括约肌结构及功能的改变以及内括约肌厚度与临床症状严重程度的关系。方法对中国医科大学附属盛京医院2008年6—12月间收治的35例功能性便秘患儿（便秘组,其中合并失禁者17例）进行肛门直肠测压和肛管内B超检测,并与同期住院治疗的23例经检查排除消化道和内分泌疾病患儿（对照组）进行对照．采用儿童便秘临床症状评分标准（65分法）评估症状的严重程度。结果便秘组与对照组相比．直肠感知阈值明显增加[（42．4±19．5）ml比（29．1±15．6）ml,P〈0．05）;引起肛门内括约肌松弛反射的最低充气量明显增高[（55．6±31．6）ml比（30．5±13．8）ml,P〈0．05）;肛门内括约肌明显增厚[（3．8±1．7）mm比（2．5±1．0）mm,P〈0．05）;但两组肛管静息压[（170．8±62．3）mmHg比（161．3±51．1）mmHg]的差异无统计学意义（P〉0．05）。便秘组患儿临床症状评分为（9．3±4．3）分：肛门内括约肌厚度与临床症状评分呈正相关（r=0．407,P=0．015）;与患儿年龄、性别及病程则无相关性（均P〉0．05）。结论功能性便秘患儿肛门内括约肌结构与功能均会发生改变。肛门内括约肌厚度在一定程度上可以反映便秘症状严重程度。     

Role of anorectal manometry in children with severe constipation

Objective Constipation is one of the most frequent disorders of the digestive tract in children and it can be an important problem in paediatric and surgical practice. Most of the time, the cause is psychological or because of a slowing of colonic transit, but it can be a sign of organic gastrointestinal outlet obstruction. Some patients with chronic constipation are resistant to a medical approach and they present with a severe form of constipation that needs recurrent hospital admission. Anorectal manometry (ARM) is a noninvasive procedure and it helps to explain the mechanisms of defecation disorders. The aim of the present study was to evaluate the role of ARM in children with severe constipation. Method From October 2003 to October 2006, in the Paediatric Surgery Unit, 85 children – aged more than 1 year – with severe constipation were seen. The mean age was 5 years (range, 1–13). At presentation, every child had abdominal and rectal examination in order to identify abdominal distension or faecal masses. Bowel preparation with enemas was performed before ARM in patient with a rectal faecaloma. Myoelectric activity of the internal anal sphincter and resting anal tone was recorded; recto‐anal inhibitory reflex (RAIR) was tested to exclude Hirschsprung’s disease (HD). Anal tone was considered normal until 50 cm H₂O. When the RAIR was absent, the patient underwent rectal suction biopsies (RSB) for histology and acetylcholinesterase histochemistry. In cases of normal or high anal tone with the RAIR present, the child had bowel cleaning, medical treatment, 2‐ and 6‐month follow‐up. Children with ineffective treatment at follow‐up underwent RSB. In case of HD, a laparoscopic‐assisted endorectal pull‐through (ERPT) according to Georgeson’s technique was performed. Results Seventy per cent of the patients had bowel preparation before ARM. In four patients the ARM was impossible to assess because of crying. In 28 patients, the anal tone result was higher than 50 cm H₂O and local treatment with anaesthetic agents was used for 8 weeks. Seventeen patients underwent RSB: 11 patients with RAIR absent/unclear, 4 noncooperative children and 2 patients with ineffective medical treatment at follow‐up. HD was diagnosed in 2 patients and laparoscopic‐assisted ERPT was performed. The remaining patients had good results at 6‐month follow‐up. Conclusion ARM is a noninvasive diagnostic tool to study the mechanism of defecation in children with constipation in order to prescribe the appropriate treatment. This procedure can be used in every child – aged more than 1 year – with severe constipation and assessment of the RAIR can select the cases for RSB.     

肛管直肠压力测定诊断盆底失弛缓综合征的临床研究

目的通过肛管直肠压力测定研究盆底失弛缓综合征(unrelaxed pelvic floor syndrome,UPFS)的肛管直肠动力学变化。方法对天津市人民医院2006年1月至2007年8月收治的有便秘症状并经排粪造影诊断为UPFS的57例病人用肛管直肠压力测定仪行肛管直肠压力测定。以无排便功能紊乱症状的30名健康志愿者作对照组。结果与对照组相比, UPFS病人肛管静息压直肠静息压差异无统计学意义(P>005),肛管最大收缩压差异具有统计学意义(P<001),力排时直肠肛管压力差差异具有统计学意义(P<001),且此压力差为负值,引起直肠初始感觉和初始便意感觉的容积及最大耐受容积差异均有统计学意义(P<001)。结论UPFS病人存在明显的直肠感觉功能下降和盆底肌肉协调运动障碍。     

结肠水疗与莫沙必利治疗慢性功能性便秘的临床对照观察

目的:观察结肠水疗对慢性功能性便秘(CFC)的治疗效果。方法:将CFC患者203例随机分A组66例,行结肠水疗;B组69例,行结肠水疗及服用枸橼酸莫沙必利治疗;C组68例,服用枸橼酸莫沙必利治疗。2周后观察疗效。结果:A,B,C 3组有效率分别为:78.79%(52/66)、86.96%(60/69)、72.06%(49/68)。经统计学处理B,C两组疗效有明显差异(P<0.05),观察有显效及有效者3、6个月,A组分别有14(26.92%)、18例(34.62%)复发;B组分别有17(28.33%)、20例(33.33%)复发,C组分别有31(63.27%)、39例(79.59%)复发。A,B结肠水疗组复发率明显低于枸橼酸莫沙必利治疗组(P<0.05)。结论:结肠水疗治疗慢性功能性便秘效果好,治愈后复发率低。     

社区小儿功能性便秘及相关因素调查研究

目的探讨永平社区儿童功能性便秘的流行病学情况及影响因素,为儿童功能性便秘的预防提供科学的依据。方法采用随机抽样调查方法,在永平社区随机抽取儿童及其家长进行问卷式调查,对确诊为功能性便秘的儿童进行临床分析。结果儿童便秘检出率为4.70%;经分析发现肥胖、偏食肉类、排便无规律、心情烦躁、饮水少、运动少等因素与儿童功能性便秘有关。结论就功能性便秘及其因素进行健康教育,普及科普知识,提高社区对本病的重视度、患者的就诊和自我保健意识,从预防角度加强对本病的防范。     

A structured bowel management program for patients with severe functional constipation can help decrease emergency department visits,hospital admissions,and healthcare costs

Background

Published health-care costs related to constipation in children in the USA are estimated at $3.9 billion/year. We sought to assess the effect of a bowel management program (BMP) on health-care utilization and costs.

青春期慢性前列腺炎及其盆底肌生物反馈治疗

目的探讨青春期慢性前列腺炎(CPP)的临床特点及盆底肌生物反馈治疗疗效。方法CPP患者25例,平均年龄16岁。下尿路相对正常研究对象15例作为对照组,平均年龄16岁。CPP患者组行慢性前列腺炎症状(NIH-CPSI)评分,前列腺按摩液(EPS)常规检查、细菌培养,行NIH分型。40例均行尿动力学检查,分析尿流曲线,记录最大尿流率(Q_(max))、剩余尿量(PVR)、逼尿肌括约肌协同失调(DSD)、最大逼尿肌排尿压(P_(det.max))、最大尿道闭合压(MUCP)等参数。CPP患者行生物反馈治疗,10周后评估疗效。结果CPP组中Ⅱ、ⅢA和ⅢB型分别为1、3和21例。治疗前CPP组和对照组Staccato排尿(20例vs．1例)和DSD (22例vs．1例)、Q_(max)(10．7±3．7 ml/s vs．15．0±4．3ml/s)、PVR(7．7±4．1 ml vs．3．2±2．6 ml)、P_(det.max)(115．1±33．6 cm H_2O vs．76．8±16．6 cm H_2O)和MUCP(176．5±45．7 cm H_2O vs．86．2±28．5 cm H_2O)比较差异有统计学意义(P＜0．05)。CPP组患者生物反馈治疗前后NIH-CPSI疼痛评分(4．6±2．2 vs．2．1±1．6)、排尿评分(7．9±2．0 vs．2．2±1．7)、生活影响评分(9．4±2．2 vs．2．6±2．1)、总分(22．0±5．2 vs．7．0±4．2)和Q_(max)(10．7±3．7 vs．14．9±5．6)差异有统计学意义(P＜0．05)。结论CPP以ⅢB型多见,临床主要表现为排尿异常,患者精神压力较大,有盆底肌功能障碍和尿动力学异常表现,盆底肌生物反馈治疗的近期疗效满意。     

A descriptive model for a multidisciplinary unit for colorectal and pelvic malformations

Introduction

Patients with anorectal malformations (ARM), Hirschsprung disease (HD), and colonic motility disorders often require care from specialists across a variety of fields, including colorectal surgery, urology, gynecology, and GI motility. We sought to describe the process of creating a collaborative process for the care of these complex patients.

Surgical management of functional constipation: An intermediate report of a new approach using a laparoscopic sigmoid resection combined with malone appendicostomy

Introduction

We previously reported our surgical technique for functional constipation for patients who have failed medical management using a novel collaborative approach with gastroenterology input, pre-operative contrast enema, colonic manometry, and laxative protocol combined with a laparoscopic colonic resection with Malone appendicostomy. Now we report our intermediate outcomes.