盆底肌电图诊断出口梗阻型便秘价值的初步探讨  

Primary Study on the Value of Pelvic Floor Electromyography in the Diagnosis of Constipation of Outlet Obstructed Type

作　　者：陈金萍[1] 刘宝华[1] 张胜本[1] 罗东林[1] 张连阳[1] 陆珂[1] 张菊馨[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所普外科,重庆400042

出　　处：《中国肛肠病杂志》2008年第1期11-14,共4页Chinese Journal of Coloproctology

摘　　要：为了探讨盆底肌电图对松弛型和痉挛型出口梗阻型便秘的诊断价值，采用美国medtronic keypoint肌电图仪对15例正常自愿者和55例出口梗阻型便秘患者进行耻骨直肠肌肌电图检测。结果：（1）定量MUP分析。正常组、松弛组在静息相和力排相的各项指标无显著性差异；痉挛组力排相的Ampl、Area和Freq明显高于本组的静息相，并且静息相的Ampl明显高于正常组和松弛组，Ar／Am明显低于正常组和松弛组（P〈0．05）。（2）干扰相分析。正常组、松弛组在静息相和力排相的各项指标无显著性差异；痉挛组力排相的Turns、Ampl、T／A、Activity、Envelop明显高于静息相，并且静息相的Turns、Ampl、T／A、Activity、Envelop明显高于正常组和松弛组（P〈O．05）。结果表明，通过对出口梗阻型便秘患者的盆底肌电图检测发现，盆底肌的异常肌电话动是痉挛型出口梗阻型便秘的主要原因，盆底肌电图（尤其是干扰相分析）能准确评价出口梗阻型便秘的盆底肌功能状态，可以用来综合评价便秘患者的病因，帮助更全面的诊断和指导临床治疗。The objective of the study was to evaluate the diagnostic value of pelvic floor electromyography in the diagnosis of the constipations of outlet obstructed type. The electromyography of the puborectal muscle was conducted in 15 healthy volunteers and 55 patients with constipation of the outlet obstructed type by using electromyograph（medtronic keypoint, USA）,among the 55 patients there were 25 flaccidtype and 30 spastic-type. The results of quantitative MUP analysis revealed that there was no marked statistical differences among the indexes of the resting phase and the straining phase in both the healthy group and the flaccid-type group;and that the indexes of amplitude, area and frequency in the spastic-type group were notably higher in the straining phase than those in the resting phase, the amplitude in the resting phase was markedly higher than those in the heathy group and that in the flaccid-type group, and the indexes of area and amplitude in the resting phase（of the spastic-type group） were much lower than that inthe healthy group and in the flaccid-type group（ P 〈0.05）. The results of interference phase analysis showed that there was no obvious statistical differences among the indexes the healthy group and the flaccid-type group during resting phase and flaccid phase;and that the indexes of turns, amplitude, T/A, activity and envelope during straining phase in the spastic-type group were much higher than those during resting phase, and the indexes of turns, amplitude,T/A, activity and envelope during resting phase in the spastic-type group were much higher than those in the healthy group and in the flaccid-type group （ P 〈0.05）. It is concluded that the abnormal myoelectric activity is the main cause of the constipation of spastic outlet obstructed type,that the pelvic floor electromyography（especially the interference phase analysis） can accurately indicate the functional status of the pelvic floor muscle and can confirm the cause of constipation, thus helping make correct diagn

关 键 词：便秘 盆底肌电图 诊断 

分 类 号：R442.2[医药卫生—诊断学] R657.16[医药卫生—临床医学]