球囊扩张训练结合盆底肌康复对脑卒中后便秘的临床效果

目的：探讨球囊扩张训练结合盆底肌康复治疗对脑卒中后便秘的疗效。方法：对复旦大学附属闵行医院神经内科收治的96例脑卒中后便秘患者,根据患者治疗意愿,同意接受球囊扩张训练治疗方法的列入治疗组,不接受球囊扩张训练治疗的为对照组,每组48例。2组患者均给予常规康复治疗：盆底肌训练、生物反馈治疗;治疗组在常规康复治疗基础上进行球囊扩张训练。所有患者均于治疗前和治疗7 d、15 d进行排便积分、肛门括约肌的RMS、iEMG评估。结果：2 组患者治疗前排便积分、RMS、iEMG差异无统计学意义（P ＞0.05）。治疗7 d和15 d时,治疗组排便积分、肛门括约肌的iEMG优于对照组,差异有统计学意义（P ＜0.01）;治疗15 d时治疗组RMS与对照组比差异有统计学意义（P ＜0.05）。2组患者便秘发生率均下降,对照组分别高于治疗组31.3%和10.4%。结论：盆底肌康复结合球囊扩张训练早期康复介入对脑卒中后便秘有较大改善。

The clinical effect of balloon dilation training combined with pelvic floor muscle rehabilitation on constipation caused by cerebral stroke

Objective: To explore the therapeutic effect of balloon dilation training combined with pelvic floor muscle rehabilitation on constipation after cerebral stroke. Methods: Totally 96 patients with constipation caused by cerebral stroke in the department of neurology of Minhang Hospital Affiliated to Fudan University were randomly divided as the treatment group and the observation group, with 48 cases in each. Both groups received conventional rehabilitation treatment, including pelvic floor muscle training and biofeedback therapy.Patients in the treatment group received balloon dilation training therapy, based on the conventional rehabilitation therapy, while the observation group did not. Before the treatment and 7 days and 15 days after treatment, all patients were evaluated by both defecation integral and RMS/iEMG assessment of anal sphincter. Results: There was no significant difference in the scores of defecation integral and RMS/iEMG of anal sphincter between the two groups before treatment (P>0.05). However, 7 days and 15 days after the balloon dilation training therapy, the scores of defecation integral and iEMG of anal sphincter in the treatment group were better than those in the observation group (P<0.01). The incidence of constipation decreased in both groups, but was higher in the observation group (31.3%) than in the treatment group (10.4%). Conclusion: The pelvic floor muscle rehabilitationcombined with balloon dilatation training can significantly improve the constipation caused by cerebral stroke.