先天性巨结肠手术后大便失禁生物反馈治疗效果的影响因素分析OA北大核心CSTPCD

Objective To explore the influncing factors for biofeedback therapeutic efficacy of fecal in-continence after pull-through in Hirschsprung's disease(HD).Methods From June 2016 to June 2023,retro-spective analysis was performed for 72 children of fecal incontinence after pull-through in HD.They were divid-ed into three groups of excellent(n=41),medium(n=22)and poor efficacy(n=9).Personal demograph-ics,clinical signs and anorectal manometry were compared among three groups.The influncing factors of bio-feedback therapeutic efficacy of fecal incontinence were examined by univariate and multivariate Logistic regres-sion.Results Single variate analysis revealed that classification of disease,supplemental household exercise,course of treatment,Vaizey score,rectal sensory volume threshold(RSVT),rectal rest pressure(RRP),anal rest pressure(ARP),anal diastolic pressure(ADP),anal maximal squeeze pressure(AMSP),anal longest squeeze time(ALST)and coordinated of anal contractions(CAC)were correlated factors of biofeedback thera-peutic efficacy of fecal incontinence after pull-through in HD(P＜0.05).Multivariate Logistic regression anal-ysis indicated that RSVT,RRP,ARP,ALST and course of treatment were the independent influncing factors of therapeutic efficacy of biofeedback.The area under the curve was 0.862(95％CI=0.771-0.953,P=0.000)with a sensitivity of 71.0％and a specificity of 82.9％.Conclusions RSVT,RRP,ARP,ALST and course of treatment are the independent influncing factors of therapeutic efficacy of biofeedback for fecal incontinence af-ter pull-through in HD.The above logit model may predict the therapeutic efficacy of biofeedback for fecal in-continence after pull-through in HD.And the recommended course of treatment is one week.