高分辨率肛门直肠测压及生物反馈治疗在功能性排便障碍的应用

目的：探讨功能性排便障碍患者的高分辨肛门直肠测压特点及生物反馈治疗对其临床症状改善情况。方法对29例功能性排便障碍患者进行高分辨肛门直肠测压及生物反馈训练治疗，每次20 min，每周3次，4周为1疗程，治疗1个疗程。分析29例治疗前高分辨肛门直肠测压特点，并比较治疗前、后患者的临床症状改善情况，评定疗效。结果29例患者中排便不协调者26例（89．7％）、排便推进力不足者3例（10．3％）。括约肌静息压松弛率小于20％为20例（69．0％）。排便反射感知阈值增加24例（82．8％）。经治疗后临床痊愈2例（6．9％），显效7例（24．1％），有效14例（48．3％），无效6例（20．7％），总有效率为79．3％。结论功能性排便障碍患者多存在盆底肌不协调收缩，排便反射感知阈值增加，生物反馈治疗能有效改善患者的排便困难症状。

Application of high resolution anorectal manometry and biofeedback in functional defecation disorders

Objective To investigate the characteristics of the high resolution anorectal manometry application in patients with functional defecation disorders,and the effect of biofeedback for improving the clin-ical symptoms.Methods Twenty-nine cases of functional defecation disorders patients were treated with high resolution anorectal manometry and biofeedback training treatment,20 minutes each time,three times a week, 4 weeks as a period of treatment,all patients received one course of treatment.These patients were followed up for a month to observe the improvement and the constipation integral result.Results Among 29 patients,26 cases （89.7%）presented with simultaneous contradiction defecation,3 cases （1 0.3%）were lack of bowel propulsion.Twenty cases’（69.0%）sphincter resting pressure relaxation rates were less than 20%;Twenty-four cases （82.8%）increased defecation reflex perception threshold.After treatment,2 cases （6.9%）were healed,7 cases （24.1%）were markedly effective,1 4 cases （48.3%）were effective,6 cases （20.7%） had no effect.The total effective rate was 79.3%.Conclusions Our study suggests that patients with func-tional defecation disorders have contradiction contraction in pelvic floor muscle and increased threshold of defe-cation reflex perception,biofeedback therapy can effectively improve the symptoms of patients with functional defecation disorders.