中西医结合护理 (Oct 2022)
Application of high-resolution anorectal manometry in postoperative pelvic floor muscle exercises in children with tethered cord syndrome (高分辨率肛门直肠测压在儿童脊髓栓系综合征术后提肛训练中的应用)
Abstract
Objective To explore the effect of preoperative high-resolution anorectal manometry-assisted pelvic floor muscle exercises on anal function recovery in children with tethered cord syndrome. Methods Totally 68 cases of patients with tethered cord syndrome were divided into a study group (n=38) and a control group(n=38). The high-resolution anorectal manometry was performed preoperatively for evaluation of functions of the anal canal. The control group received routine nursing and health education, and the study group received an intervention of exercise for strengthening levator ani muscles. The results of anorectal pressure measurement were analyzed during postoperative follow-up, and the recovery of anal function was compared between two groups. Results There was no significant difference in anal canal resting pressure and maximum anal squeeze pressure between two groups before surgery(P＞0. 05). After a three-month follow-up, better outcomes of anal canal resting pressure, rectal sensitivity test and maximum anal squeeze pressure were measured in the study group compared with that in the control group (P＜0. 05). Conclusion Based on the evaluation results of preoperative anorectal pressure measurement, targeted pelvic floor muscle exercises can help children with anal function recovery. (目的 探讨高分辨率肛门直肠测压技术指导下的提肛训练在儿童脊髓栓系综合征患儿术后肛管功能恢复中的应用效果。方法 68例脊髓栓系综合症行手术治疗的患儿分为试验组38例和对照组30例。采用高分辨率多通道胃肠功能检测系统对脊髓栓系患儿术前的肛管功能进行评估。对照组接受常规护理和健康宣教, 试验组由护士根据测压结果给予盆底肌肉功能锻炼为主的提肛训练。术后随访患儿肛门直肠测压结果并分析, 比较两组患儿术后肛管功能的恢复情况。结果 术前两组肛管静息压、肛管最大收缩压比较, 差异无统计学意义(P＞0. 05)。术后3个月后门诊随访, 试验组患儿肛管静息压力明显高于对照组, 直肠敏感性、肛管最大收缩压监测结果试验组要明显优于对照组, 差异有统计学意义(P＜0. 05)。结论 结合患儿术前肛门直肠测压的评估结果, 有针对性地开展术后提肛训练, 有助于患儿肛门功能的恢复。)
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