邓春友　谢永康　利友琼等

[摘要] 目的 探讨排便技术训练对功能性便秘患者临床症状及肛管直肠功能的影响。 方法 选取本院2010年3月～2012年2月收治的36例功能性便秘患者作为对照组，给予常规综合干预措施。选取本院2012年3月～2014年2月收治的40例功能性便秘患者作为研究组，在对照组的基础上给排便技术训练方案。比较两组干预前后的肛管直肠压力、直肠感觉功能及排便基本情况。 结果 研究组干预后的肛管静息压、肛门最大收缩压、用力排便时直肠压力显著高于对照组，差异有统计学意义（P<0.05）。研究组干预后的直肠初始感觉容量、直肠初始便意感觉容量、排便窘迫容量及直肠最大耐受容量显著低于对照组，差异有统计学意义（P<0.05）。研究组干预后的便秘症状评分显著低于对照组，差异有统计学意义（P<0.05）。 结论 排便技术训练方案在功能性便秘患者中的应用效果显著，能有效改善患者的直肠肛管受损程度，并促进正常排便，减轻不良症状。

[关键词] 功能性便秘；排便技术；临床症状；肛管直肠功能

[中图分类号] R471 [文献标识码] A [文章编号] 1674-4721（2015）05（c）-0162-04

[Abstract] Objective To explore the influence of defecation technology training on clinical symptoms and anorectal function in patients with functional constipation. Methods 36 cases with functional constipation in our hospital from March 2010 to February 2012 were selected as the control group，which was given comprehensive intervention measures.40 cases with functional constipation in our hospital from March 2012 to February 2014 were selected as the study group，which was given defecation technology training program on the basis of the control group.The anorectal pressure，rectal sensory function and defecation basic situation in two groups before and after intervention was compared respectively. Results The anal resting pressure，anal maximal systolic pressure，forced defecation rectal pressure in the study group after intervention was higher than that in the comtrol group，with significant difference（P<0.05）.The the rectal initial sensory capacity，rectal defecation，defecation capacity initial feeling of distress capacity and rectal maximum tolerable volume in the study group after intervention was lower than that in the comtrol group，with significant difference（P<0.05）.The score of constipation symptom in the study group after intervention was lower than that in the comtrol group，with significant difference（P<0.05）. Conclusion The application effect of defecation technology training programme on clinical symptoms and anorectal function in patients with functional constipation is significant，which can effectively improve the extent of the anorectal damage in patients with functional constipation，promote normal defecation，reduce adverse symptoms.

[Key words] Functional constipation；Defecation technology；Clinical symptom；Anorectal function

近年来，随着我国居民饮食结构的改变以及生活压力的增高，慢性胃肠道疾病的发病率也呈逐年上升趋势[1]，其中以功能性便秘最为常见[2]。流行病学研究资料显示，该病在欧美国家的发病率高达15%左右，在我国发病率可达30%左右，已引起医务人员的极大关注[3]。基于此，有学者对本病的病因、影响因素及干预措施等方面进行研究，并指出该病与患者长期所经历的负性情感、肠蠕动功能减弱及刻意控制排便等因素相关[4]。此外，亦有文献报道，功能性便秘患者的肛管静息压、直肠敏感性及顺应性与正常人存在明显差异[5]，提示肛管直肠功能是导致该病发生及进展的主要诱因。本研究选取本院的功能性便秘患者作为研究对象，探讨排便技术训练对功能性便秘患者临床症状及肛管直肠功能的影响。……