体位与直肠内容物对脱垂型痔疮患者肛门直肠压力的影响  

The Influence of Different Positions and Inflating Materials of Anorectal Manometry for Patients with Prolapsed Hemorrhoids

作　　者：王琛[1] 周清[1] 

机构地区：[1]上海中医药大学附属龙华医院肛肠科,上海200032

出　　处：《复旦学报（自然科学版）》2013年第5期669-673,680,共6页Journal of Fudan University：Natural Science

基　　金：上海市科委医学引导项目(13401905200);龙医团队基金(LYTD-06)资助

摘　　要：研究体位因素和直肠内容物性质对脱垂型痔疮患者的肛门直肠压力和感觉阈值的影响,从而探寻能客观反映脱垂型痔疮患者症状体征的测压方法.采用灌注式肛肠压力仪对20例脱垂型痔疮患者(男∶女=1∶1)分别进行蹲位、左侧卧位和坐位时的肛门直肠压力测定,同时使用气体和液体分别观察感觉阈值并进行分析.有17例患者(9男8女)完成全部数据测量,其中肛管长度、直肠静息压、肛管静息压、肛管最大收缩压在蹲位、坐位和左侧卧位间有明显差异且均以左侧卧位值最小(p<0.05),感觉阈值方面液体的初始感觉阈值在3种体位间有显著差异并以蹲位最小,左侧卧位最大,而气体的初始感觉阈值在左侧卧位明显小于液体(p=0.02).所有患者肛门直肠抑制反射均为阳性.脱垂型痔疮患者的肛门直肠压力受到体位因素影响,患者的肛管长度、肛管直肠压力和部分感觉阈值在3种体位间有明显差异,但直肠内容物性质对感觉阈值影响不明显.对于脱垂型痔疮患者采用坐位进行肛门直肠压力测定最为适宜.It was to find out the influence of different positions and inflation materials of anorectal manometry for patients with prolapsed hemorrhoids. Fluid filled 8 channel radial catheter equipment was used to measure 20 prolapsed hemorrhoid patients （male ： female= 1 ： 1）. Three different positions as squatting, left lateral and sitting and two different materials as air and water had been used to measure the pressure and sensation threshold. Only 17 patients（9 male, 8 femal） successively underwent anorectal manometry in three positions. There were significant differences among the three positions regarding sphincter length, rectum resting pressure, anal resting pressure, maximum voluntary squeeze pressure and the first sensory volume （P^0. 05）. The first sensory volume of air in left lateral position was significantly less than water （P=0. 02）. Rectoanal inhibitory reflex was normal in all patients. Different positions effecte the anorectal manometric results of patients with prolapsed hemorrhoids. Sitting position is more acceptable and convenient either to doctor or to patients.

关 键 词：脱垂型痔疮 体位 直肠内容物 肛门直肠压力检测 

分 类 号：R657.1[医药卫生—外科学]