盆底失弛缓型便秘直肠感觉功能及肛管动力学变化  

Anorectal sensation function and changes of anal canal dynamics in pelvic achalasia constipation

作　　者：鲍聚喜[1] 张光鑫[1] 张孝通[1] 杨凤霞[1] 

机构地区：[1]解放军第五医院肛肠外科,宁夏银川750004

出　　处：《西北国防医学杂志》2013年第2期120-122,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:通过研究盆底失弛缓型便秘直肠感觉功能及肛管动力学变化,了解盆底失弛缓型便秘的肛管直肠动力学特征,以期研究盆底失弛缓型便秘的发病机理,确定最佳的治疗方法。方法:采用ZJ-D3直肠压力测定仪、生物刺激反馈仪,对36例盆底失弛缓型便秘患者与28例健康对照者分组进行直肠一肛管的压力变化测定及表面肌电状态评估,测定直肠一肛管的压力变化及直肠对容量刺激的感觉阈值、排便阈值、直肠的顺应性和表面肌电基线并比较其差别。结果:直肠肛门的收缩压、肛门内外扩约肌的净减压,与对照组相比差异无显著性(P>0.01),而直肠肛管的静息压、肛管高压带长度、肛管直肠的屏障压、直肠对量刺激的感觉阈值、排便阈值、直肠的顺应性及前基线与对照组差别显著(P<0.01)。结论:直肠感觉功能异常及盆底肌肉动作不协调是盆底失弛缓型便秘的主要发病原因。Objective： To study the anorectal sensation function and the changes of anal canal dynamics in pelvic achalasia constipation, in order to study pelvic achalasia constipation pathogenesis and to determine the best treatment method. Methods： ZJ -D3 rectal pressure measuring instrument and biological stimulation feedback instrument were used to evaluate the pressure change and the surface electromyographic state of the rectum canal in 36 cases with the pelvic achalasia constipation and 28 healthy volunteers as control. We determined the pressure change of rectum anal canal, the thresholds rectal sensation and the stimulation threshold, the rectal compliance of defecation and surface EMG baseline, and compared their differences. Results： There was no significant difference in the contractived pressure of the anorectal and the net decompression of the internal external anal sphincter com- pard with the control group （ P 〉 0.01 ）, whereas significant difference was found in anal resting pressure, length of anal canal rectum anal high pressure, the barrier pressure, rectal sensory thresholds, capacity of stimulation thresh- old, defecation rectal compliance and former baseline between the two groups （P 〈 O. 01 ）. Conclusion： Rectal sensation dysfunction and pelvic floor muscle movement dyssynchrony were the main causes for pelvic achalasia constipation.

关 键 词：盆底失弛缓型便秘 肛门直肠测压 肛管动力学 

分 类 号：R657.1[医药卫生—外科学]