生物反馈训练对预防直肠癌患者保肛术后前切除综合征的效果评价

doi:10.3761/j.issn.0254-1769.2019.07.014

摘要/Abstract

摘要：

目的探讨生物反馈训练对预防中低位直肠癌患者保肛术后前切除综合征的效果。方法将拟接受术前放化疗、直肠前切除术和预防性造口的中低位直肠癌患者随机分为试验组（35例）和对照组（36例）;试验组在盆底肌功能锻炼的基础上进行生物反馈训练,对照组进行盆底肌功能锻炼。用固态肛门直肠高分辨测压设备对患者进行肛门直肠测压,并评价患者直肠前切除综合征的发生情况。结果试验组的直肠最大耐受容量和直肠顺应性显著高于对照组（P<0.05）;试验组直肠前切除综合征的发生率低于对照组（P<0.05）。结论生物反馈训练能促进中低位直肠癌患者术后感觉功能的恢复,并降低前切除综合征的发生率。

关键词: 直肠肿瘤, 手术后并发症, 神经反馈, 抗阻训练, 康复护理

Abstract:

Objective To evaluate the effects of biofeedback training on prevention of anterior resection syndrome in rectal cancer patients underwent anus-preserving surgery.Methods Using randomized controlled trial design,71 rectal cancer patients were randomly divided into the pelvic floor muscle exercise group and biofeedback training group. High resolution anorectal manometry was used for 6 longitudinal traces in 18 months.Results Rectal maximal tolerable volume and rectal compliance in the biofeedback training group were significant higher than those in the pelvic floor muscle exercise group（P<0.05）,and biofeedback training decreased the occurrence of anterior resection syndrome（P<0.05）.Conclusion The biofeedback training can significantly improve the sensory indicators of patients with middle and low rectal cancer,promote recovery and prevent anterior resection syndrome.

Key words: Rectal Neoplasms, Postoperative Complications, Neurofeedback, Resistance Training, Rehabilitation Nursing

郑美春, 吴晓丹, 姜武, 温咏珊, 阳霞, 潘志忠. 生物反馈训练对预防直肠癌患者保肛术后前切除综合征的效果评价[J]. 中华护理杂志, 2019, 54(7): 1032-1037.

ZHENG Meichun, WU Xiaodan, JIANG Wu, WEN Yongshan, YANG Xia, PAN Zhizhong. Effects of biofeedback training on prevention of anterior resection syndrome in rectal cancer patients underwent anus-preserving surgery[J]. Chinese Journal of Nursing, 2019, 54(7): 1032-1037.

图/表 1

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项目	试验组 (n=35)	对照组	统计	P值
项目	试验组 (n=35)	(n=36)	量值	P值
年龄(岁,$\bar{x}$±s）	54.34±9.94	52.50±10.44	-0.761¹⁾	0.449
性别[例(百分比,％)]			0.115²⁾	0.734
男	25(71.4)	27(75.0)
女	10(28.6)	9(25.0)
文化程度[例(百分比,％)]			1.320²⁾	0.858
小学	9(25.7)	11(30.6)
初中	12(34.3)	15(41.7)
高中/中专	9(25.7)	6(16.7)
本科/大专	2(5.7)	2(5.5)
硕士以上	3(8.6)	2(5.5)
肿瘤距肛门距离	5.00±1.63	5.06±1.88	0.133²⁾	0.895
(cm,$\bar{x}$±s）
肿瘤临床分期[例(百分			0.119²⁾	0.73
比,％)]
域期	26(74.3)	28(77.8)
芋期	9(25.7)	8(22.2)
手术方式[例(百分比,％)]			0.162²⁾	0.688
开腹Dixon术	5(14.3)	4(11.1)
腹腔镜辅助下Dixon术	30(85.7)	32(88.9)

项目	试验组 (n=35)	对照组	统计	P值
项目	试验组 (n=35)	(n=36)	量值	P值
年龄(岁,$\bar{x}$±s）	54.34±9.94	52.50±10.44	-0.761¹⁾	0.449
性别[例(百分比,％)]			0.115²⁾	0.734
男	25(71.4)	27(75.0)
女	10(28.6)	9(25.0)
文化程度[例(百分比,％)]			1.320²⁾	0.858
小学	9(25.7)	11(30.6)
初中	12(34.3)	15(41.7)
高中/中专	9(25.7)	6(16.7)
本科/大专	2(5.7)	2(5.5)
硕士以上	3(8.6)	2(5.5)
肿瘤距肛门距离	5.00±1.63	5.06±1.88	0.133²⁾	0.895
(cm,$\bar{x}$±s）
肿瘤临床分期[例(百分			0.119²⁾	0.73
比,％)]
域期	26(74.3)	28(77.8)
芋期	9(25.7)	8(22.2)
手术方式[例(百分比,％)]			0.162²⁾	0.688
开腹Dixon术	5(14.3)	4(11.1)
腹腔镜辅助下Dixon术	30(85.7)	32(88.9)