| BackgroundFunctional incontinence(FI)refers to the previous normal defecation in patients over 4years old,at least 3 months of recurrent,uncontrollable stool outflow,and no neurogenic and anatomical abnormal etiology changes,With uncontrolled fecal leakage and contaminated clothes at inappropriate time and place,seriously affecting the quality of life of patients.At present,the etiology and pathogenesis of FI are not clear,and may be related to risk factors such as age,decreased cognitive ability and diarrhea.Previous research showed that electrostimulating biological feedback in the treatment of congenital giant colon modified Soave after postoperative stool feces was simple,non-invasive and had significant effect.ObjectiveTo investigate the effect of biofeedback pelvic floor exercise on functional fecal incontinence in children and the changes of electromyography(EMG)in order to provide clinical basis for the treatment of functional fecal incontinence in children.Methods32 cases of functional fecal incontinence in our hospital from 2018 to 2020 were collected,19 were male,13 were female,age range 6～13 years old,mean age 7.93 years old.The pelvic floor muscle biofeedback therapy were conducted with Laborie biofeedback instrument,40 minutes at a time,once a day,one cycle treatment took ten times and more than 200 times of pelvic floor muscle contraction training every day.The anal canal current intensity(m A),anal basic motor EMG(μv),anal contraction myoelectric difference(μv)and anal continuous contraction time(s)were measured before treatment,day 10 after treatment,day 30 after treatment and 1 year after treatment respectively.Ten children of small penis with normal anal and rectal function and no other organic diseases were selected as control groups.Results1、On the 10 th day after treatment,the FECAL symptoms of 32 patients(100%)have disappeared.The current intensity of anal canal has descended from [(15.87±2.59)m A]which is tested before treatment to [(12.00±2.16)m A].Compared with the contrast group[(7.10±1.93)m A],the differences were statistically significant(P<0.05).The EMG value of basic movement of anal canal has descended from[(209.47±33.13)μv] which is tested before treatment to [(138.31±46.99)μv].Compared with the contrast group[(85.86±34.73)μv],the differences were statistically significant(P<0.05).The contractile muscle’s electrical difference of anal canal has ascended from[(45.27±27.6)μv] which is tested before treatment to [(92.91 ± 45.06)μv].Compared with the contrast group[(127.29±51.89)μv],the differences were statistically significant(P<0.05).The duration of continuous contraction of anus has ascended from[(1.21±0.57)s] which is tested before treatment to [(2.07±0.79)s].Compared with the contrast group [(2.62±0.64)s],the differences were statistically significant(P<0.05).2、On the 30 th day after treatment,all the patients don’t appear the FECAL symptoms.Anal canal current intensity [(8.00±0.93)m A]、anal canal basal motor electromyography[(90.56±19.11)μv]、anal canal contraction electromyography difference [(110.22±36.71)μv]and anal continuous contraction time [(2.47±0.66)s],Compared with the control group,there was no significant difference(P>0.05).3、Follow-up 1 year,missing 5 people.One year after treatment,All patients were free of faeces,Anal canal current intensity[(7.44±1.42)m A] 、 anal canal basal motor electromyography [(87.11±34.10)μv]、anal canal contraction electromyography difference[(125.56±36.44)μv] and anal continuous contraction time [(2.57±0.54)s],Compared with the control group,there was no significant difference(P>0.05).Conclusion1、Biofeedback pelvic floor exercise is a non-invasive,safe,simple and effective treatment for functional fecal incontinence in children.2、Long-term sustainability and exactly pelvic floor muscle function exercise is needed to consolidate the curative effect and avoid recurrence of feces. |
PDF Full Text Request