摘要目的 评价骶神经电刺激(SNS)治疗功能性肛门直肠痛(FAP)的疗效.方法 回顾性分析2011年3-12月间在山东大学附属千佛山医院接受经骶3神经孔行SNS治疗的32例FAP患者的临床资料.分别通过疼痛视觉模拟评分(VAS)、肛门直肠测压及健康调查简表(SF-36)来评估临床症状缓解、肛门动力学及生活质量改善情况.结果 SNS治疗后,患者VAS评分显著降低,直肠肛门反射阈值容积上升,肛管最大收缩压和肛管静息压显著降低(均P＜0.01).SF-36量表调查显示,除一般健康外,其余维度的评分明显升高(P＜0.05或P＜0.01).治疗后3个月,临床治愈19例,有效12例(其中显效7例),无效1例,总有效率为96.9％.结论 SNS为治疗FAP提供了一种新的安全、有效的治疗方法,不仅可显著改善疼痛症状,而且提高了患者的生活质量.

abstractsObjective To evaluate the treatment outcomes of sacral nerve stimulation(SNS) for functional anorectal pain (FAP).Methods A total of 32 patients of FAP received SNS treatment through S3 from March 2011 to December 2011.Visual analogue scale (VAS),anal pressure measure,and health survey (SF-36) before and after treatment were used to evaluate the outcomes.Results After treatment,VAS score was significantly decreased,rectal anal reflex threshold volume elevated,and anal maximum contraction pressure (AMCP) and anal rest pressure significantly decreased compared with those before treatment (all P＜0.01).Except for general health,the remaining dimension score of the SF-36 increased significantly after treatment,and the differences were statistically significant (P＜0.05 or P＜0.01).After SNS treatment,19 cases were cured,12 improved,1 was refractory.The total effective rate was 96.9％ during 3 months after treatment.Conclusion SNS is a safe and effective alternative for FAP and can alleviate the pain symptom and improve the quality of life.