gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2016-0-3-48-54gnck-34Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESДИАГНОСТИКА И КОНСЕРВАТИВНОЕ ЛЕЧЕНИЕ ФУНКЦИОНАЛЬНЫХ РАССТРОЙСТВ ДЕФЕКАЦИИDIAGNOSIS AND CONSERVATIVE TREATMENT OF FUNCTIONAL DISORDERS OF DEFECATIONФоменкоОксана ЮрьевнаFomenkoO. U.info@gnck.ruТитовА. Ю.TitovA. U.noemail@neicon.ruБирюковО. М.BirukovO. M.noemail@neicon.ruМудровА. А.MudrovA. A.noemail@neicon.ruБелоусоваС. В.BelousovaS. V.noemail@neicon.ruЕгороваД. В.EgorovaD. V.noemail@neicon.ruФГБУ «ГНЦК им. А.Н. Рыжих» Минздрава РоссииРоссияState Scientific Center of ColoproctologyRussian FederationФГБУ «ГНЦК им. А.Н. Рыжих» Минздрава России; ГБОУ ДПО РМАПО Минздрава РоссииРоссияState Scientific Center of ColoproctologyRussian Federation201630092016034854Copyright © Фоменко О.Ю., Титов А.Ю., Бирюков О.М., Мудров А.А., Белоусова С.В., Егорова Д.В., 20162016Фоменко О.Ю., Титов А.Ю., Бирюков О.М., Мудров А.А., Белоусова С.В., Егорова Д.В.Fomenko O.U., Titov A.U., Birukov O.M., Mudrov A.A., Belousova S.V., Egorova D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/34

В исследование включено 90 пациентов с функциональными расстройствами дефекации - диссинергическая дефекация и неадекватная пропульсия. Женщин было 72 (80%), мужчин - 18 (20%), средний возраст составил 43,6±16,5 лет. Согласно опросу, все пациенты удовлетворяли Римским критериям III (2006) функционального запора. Всем пациентам была выполнена аноректальная манометрия высокого разрешения на гастроэнтерологическом комплексе Solar (фирмы MMS, Нидерланды) с помощью 8-ми канальных перфузионных катетеров водного наполнения. Использовался Лондонский Протокол HRAM. Всем пациентам проведена БОС-терапия по программе обструктивной дефекации на аппарате Urostim (производитель Laborie, Канада). Курс лечения включал 10 ежедневных сеансов общей продолжительностью 30 мин. Эффективность лечения оценивалась непосредственно после завершения курса БОС-терапии по результатам повторной аноректальной манометрии высокого разрешения. ЗАКЛЮЧЕНИЕ. По данным функциональных исследований метод биологической обратной связи может быть применен для лечения пациентов с синдромом обструктивной дефекации при наличии диссинергии мышц тазового дна в виде спазма пуборектальной петли. При этом БОС-терапия неэффективна у пациентов с III типом манометрического паттерна и у больных с неадекватной пропульсией.

90 patients (female 72 (80%), male 18 (20%), mean age 43,6±16,5 y.o.) with functional disorders of defecation (dyssynergic defecation and inadequate propulsion) were included in the study. All the patients conformed the Rome III (2006) criteria for functional constipation. Highresolution anorectal manometry (HRAM) procedures (London protocol) were performed using Solar GI system (MMS, The Netherland) with 8-channel water-perfusion catheters. All the patients underwent a course of biofeedback therapy for obstructive defecation (Urostim, Laborie, Canada). The course consisted of 10 daily 30-minutes long sessions. Treatment efficacy was evaluated after the completion of biofeedback therapy according to the control HRAM. CONCLUSIONS. Biofeedback is the method of choice for treatment of patients with obstructive defecation syndrome with pelvic floor dyssynergia and spasm of m.puborectalis. At the same time biofeedback therapy is ineffective in patients with type III of manometry pattern and in patients with an inadequate propulsion.

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The authors declare that there are no conflicts of interest present.