直肠内脱垂病人直肠形态研究及临床意义  

Study of the Morphology of Rectum and Its Clinical Value in Patients with Internal Prolapse of Rectum

作　　者：李冠武[1] 顾强[1] 谢禹昌[1] 陈义磊[1] 赵振国[1] 

机构地区：[1]浦东新区人民医院放射科,上海201200

出　　处：《实用放射学杂志》2010年第4期526-528,共3页Journal of Practical Radiology

基　　金：浦东新区卫生系统重点学科建设项目（PWZXK2007-14）.

摘　　要：目的评价直肠内脱垂病人直肠形态结构变化及其临床意义。方法31例功能性便秘患者及10例正常对照组行排粪造影评估直肠内脱垂的直肠形态学改变。数据采用Mann—Whitney U非参数法及Fisher’s精确检验。结果病人组与对照组直肠全层内套叠分别为23／31例、2／10例，Fisher’s精确检验P=0．007，差别有显著统计学意义；病人组与对照组直肠前壁折叠厚度分别为（13．51±9．42）mm及（3．68±2．34）mm，后壁折叠厚度（5．36±3．92）mm及（2．82±0．99）mm，套叠鞘部直径（37．19±11．79）mm及（25．32±9．25）mm、套入部内口径（14．91±4．74）mm及（19．73±6．36）mm、套叠鞘部直径与套入部内口径之比2．82±1．64及1．28±0．12、静息时直肠最大直径（48．97±9．55）mm及（39．84±8．45）iTIrlq，各项差异均有统计学意义（P〈0．05）。结论排粪造影可正确区分直肠全层内套叠或直肠黏膜内脱垂，为选择合理的治疗方案提供依据，但基于排粪造影而行治疗干预必须谨慎。ObJective To evaluate the changes of rectal morphology and its clinical value in internal rectal prolapse. Methods The rectal morphology of internal rectal prolapse in thirty--one patients with functional constipation and ten normal control subjects was analysed with defecography. The data were analysed with Mann--Whitney Unonparametric test and Fisher＇s exact test. Results 23 cases and 2 cases with rectal intussusception in patients group and control group respectively were found. Fisher＇s exact test was P= 0. 007. In patients group and control group, the thicknesses of anterior intussusception were （13.51 ± 9.42） mm and （3.68 ± 2.34） mm,and posterior intussusception were （5.36±3.92） mm and （2. 82±0. 99） mm respectively;the intussuscipiens diameters were （37. 19±11. 79） mm and （25.32±9. 25） mm,the intussusceptum lumen diameters were （14.91±4.74） mm and （19.73±6.36） mm,the ratio of intussuscipiens diameters and lumen diameters were 2. 82 ± 1. 64 and 1.28 ± 0. 12, the maximum rectal diameter were （48.97±9.55） mm and （39.84±28.45） mm at rest state. There were significant differences between patients group and control group in above varied values（P〈0. 05）. Conclusion Defecography can differentiate whole thickness rectal intussusception from rectal mucosal prolapse, which provides the scientific basis for choosing the reasonable treatment. However, caution is required when selecting patients for treatment interventions based on defecography.

关 键 词：直肠 直肠内脱垂 功能性便秘 排粪造影 X线摄影 

分 类 号：R574.63[医药卫生—消化系统] R442.2[医药卫生—内科学]