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변비의 바이오피드백 치료 호응도에 영향을 미치는 인자들에 대한 임상적 고찰: 항문직장 생리검사를 중심으로

Are There Anorectal Physiologic Factors Prior to Biofeedback Treatment for Constipation that Affect Compliance Rate?

대한대장항문학회지 2006년 22권 3호 p.162 ~ 168
신동호 ( Shin Dong-Ho ) - 강동서울외과

김승철 ( Kim Seung-Chul ) - 강동서울외과
김인경 ( Kim In-Kyung ) - 강동서울외과
홍현기 ( Hong Hyun-Ki ) - 강동서울외과
주재식 ( Joo Jae-Sik ) - 강동서울외과

Abstract


Purpose: The most important factor for the success of biofeedback treatment of constipation is patients’ enthusiastic participation and willingness to comply with the treatment protocol. The purpose of this study was to analyze differences among groups of patients classified according to the number of biofeedback sessions and to identify any anorectal physiological and clinical factors related with better compliance with biofeedback treatment.

Methods: From Aug. 2001 to July 2003, 80 patients who had undergone biofeedback treatment for constipation by a single therapist were classified into three groups according to the number of sessions: only one session (Group I, n=26), two or three sessions (Group II, n=27), and more than four sessions (Group III, n=27). We reviewed the clinical and the anorectal physiological characteristics retrospectively.

Results: The mean age was 39.1 (range, 8∼77) years, and the mean duration of constipation was 7.7 (range, 0.5∼30) years and mean frequency of defecation was 2.2 times/week. Patients’ pretreatment use of laxatives was significantly lower in Group I (38.5 percent) than in Group II (70.4 percent) or Group III (51.9 percent) (P<0.05). There were no significant differences in anal manometric parameters (mean and maximal resting pressure, maximal squeezing pressure, sensitivity, and rectal capacity). In the cinedefecographic findings, the megarectum was significantly higher in Group III (58.3 percent) than in Group I (38.9 percent) or Group II (27.8 percent) (P=0.02), but other findings of anismus, rectocele, intussusception, and delayed emptying showed no significant differences. The cinedefecographic parameters (anorectal angle, perineal descent, anal canal length, and puborectalis length), were not significantiy different among the groups.

Conclusions: We strongly recommend biofeedback treatment for constipation patients who abuse laxatives and/or for whom cinedefecography reveals megarectum. J Korean Soc Coloproctol 2006;22:162-168

키워드

바이오피드백 치료;호응도;변비약;거대직장
Biofeedback treatment;Compliance;Laxatives;Megarectum
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