不同年龄功能性便秘患者直肠肛管测压特点的研究  

The Anoreetal Motility and Rectal Sensation in Functional Constipation Patients with Different Age

作　　者：杨润芝[1] 吴素芬[1] 黄爱霞[1] 余容[1] 

机构地区：[1]黄石市第五医院消化内科,黄石435005

出　　处：《临床消化病杂志》2010年第6期349-350,371,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的通过对老年人与非老年人功能性便秘患者直肠肛管测压结果的研究,探讨不同年龄的功能性便秘患者直肠动力学及感觉功能的特点,以指导临床治疗方法的选择。方法采用瑞典Medtronic公司生产的8通道水灌注式消化道压力检测仪对30例老年人功能性便秘患者及30例非老年功能性便秘患者进行直肠肛管压力及感觉的测定。结果老年功能性便秘患者直肠静息压、直肠初始感觉阈值、直肠最大耐受量及模拟排便肛管不松弛与非老年功能性便秘者比较无显著性差异(P>0.05),二者大多存在初始感觉阈值、直肠最大耐受量增高及模拟排便肛管压力异常升高;老年功能性便秘患者肛管静息压和肛管最大缩窄压与非老年患者有显著差异(P<0.05),引起直肠抑制反射(RIRA)的最小气体容量二者比较存在差异(P<0.05)。老年组患者高于非老年组患者。模拟排便时老年功能性便秘者直肠压力升高多较低。结论老年功能性便秘患者直肠对容量刺激存在低敏感、高耐受、高顺应性,且肛门、直肠的协调收缩功能紊乱;促胃肠动力药物能促进肛门、直肠协调收缩作用,因此除了生物反馈治疗外,老年功能性便秘患者,促胃肠动力药物可作为重要治疗手段。Objective To study the anoreetal motility and rectal sensation in elderly patients and non-elderly patients with functional constipation.Methods 30 elderly patients and 30 non-elderly patients with functional constipation were enrolled in the study,the anorectal motility and rectal sensation of the patients with functional constipation were dectected by Medtronic PC-Polygraf HR（made by Sweden）.Results There was no significant difference with the rectal lowest volume of sensory threshold,the maximal volume of tolerance,maximal compliance and the morbidity of anorectal synchronous contraction between the two groups（P0.05）.The pressure of anal sphincter and the maximal squeeze pressure in elderly patients were lower than those in non-elderly patients,and the difference was significant（P0.01）.The threshold volume of gas to induce RIRA was significantly larger in elderly patients than in non-elderly patients（P0.05）.The anorectal synchronous aontraction when excretive action was imitated,which was lower in non-elderly patients.Conclusion Lower sensitivity higher tolerance and compliance of rectum and the disturbances of anorectal coordinating conteaction may be associated with elderly functional constipation,Gastrointestinal prokinetic agent,which can improve the function of anorectal coordinating contraction may be beneficial to the cases with functional constipation in elderly patients,besides biofeedback training.

关 键 词：老年人和非老年人 功能性便秘 直肠肛管测压 

分 类 号：R574.6[医药卫生—消化系统]