변실금 환자에서 바이오피드백 치료의 효과
Effect of Biofeedback Treatment in Patients with Fecal Incontinence
박인자, 유창식, 김희철, 정영학, 한경록, 박상규, 김정랑, 송진숙, 이향란, 김진천,
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박인자 ( Park In-Ja )
울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 외과학교실
정영학 ( Jung Young-Hak )
울산대학교 의과대학 외과학교실
한경록 ( Han Kyong-Rok )
울산대학교 의과대학 외과학교실
박상규 ( Park Sang-Kyu )
울산대학교 의과대학 외과학교실
김정랑 ( Kim Jung-Rang )
울산대학교 의과대학 외과학교실
송진숙 ( Song Jin-Sook )
울산대학교 의과대학 외과학교실
이향란 ( Lee Hyang-Ran )
울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
KMID : 0356720050210030138
Abstract
Purpose: We aimed to assess the efficacy of biofeedback therapy for patients with fecal incontinence (FI) according to the etiology.
Methods: Twenty-nine patients with fecal incontinence were treated with biofeedback therapy using a EMG-based system. The efficacy was assessed by using changes in the FI score (Cleveland Clinic, Florida: 0～20) and satisfaction based on a subjective evaluation score from 0 to 100. The median follow up duration was 12 (3～25) months.
Results: Ten patients had idiopathic fecal incontinence. Fourteen patients had fecal incontinence due to a sphincter saving operation for rectal cancer. Four cases had spinal cord injury and one patient had a major external sphincter tearing due to trauma. The mean age was 52 (16～78) years. The median number of biofeedback sessions was 10 (3～15) overall. The mean efficacy was 42.8%, and the mean satisfaction score was 56.6. Improvements in the FI score and in the patients’ satisfaction varied according to the etiology, 69.5% and 71.5 in the idiopathic group, 28.5% and 49.3 in the postoperative group, and 35% and 24 in the spinal cord injury group. In the idiopathic group, 50% of the patients showed an improvement in the FI score of more than 75%, and 90% of the patients showed an improvement of more than 50%. The number of liquid incontinence episodes was improved 78.3% later in the biofeedback group, and this result was much better than in the postoperative incontinence group (31.8%, p=0.03).
Conclusions: The success rate of the biofeedback therapy for fecal incontinence is acceptable. Subjective satisfaction is relatively higher than the improvement in the fecal incontinence score. Idiopathic fecal incontinence may be the best indication for biofeedback therapy. J Korean Soc Coloproctol 2005;21:138-144
키워드
바이오피드백;변실금;특발성
Biofeedback;Fecal incontinence;Idiopathic
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