人工泵式肛门括约肌节制排便的最适肠管约束压选择  

The appropriate choice of bowel-restrained pressure for the control of fecal incontinence by using artificial anal sphincter

作　　者：潘伟华[1,2] 施诚仁[1,2] 金凌宇[1,2] 吴燕[1,2] 吴晔明[1,2] 王玲华[1,2] 

机构地区：[1]上海第二医科大学附属新华医院小儿外科 [2]上海市儿童医学中心小儿外科,上海200127

出　　处：《临床儿科杂志》2001年第4期217-220,共4页Journal of Clinical Pediatrics

基　　金：国家自然科学基金

摘　　要：人工泵式括约肌是一种治疗大便失禁的新方法,为探明人工泵式括约肌的最佳肠管约束压,将离体和在体肠管的远端以人工泵式括约肌的袖套包裹,分别向袖套内注水1.5ml、2.0ml、2.5ml和3.0ml,然后向近端肠腔内注水直至出现渗漏,记录不同肠管容积下的肠腔内压及最大肠腔容积。结果:当袖套内注水达2.5ml时,肠管约束压可达到155cmH_2O,其肠腔内压和肠腔内容积均高于1.5ml和2.0ml组;当袖套内注水达3.0ml时,肠腔内压略高于2.5ml组,而两组所能维持的肠腔内液体容积均为40ml;在体实验于术后2周、4周、6周和8周复查无明显改变。结果表明,袖套内注水2.5ml可获得最适肠管约束压。人工泵式括约肌节制排便有良好效果。The artificial anal sphincter is a new device for the treatment of fecal incontinence. The present study tried to explore the appropriate bowel-restrained pressure of the artificial anal sphincter. The distal bowels of either isolated bowel or living dogs were wrapped up with the cuff of the artificial anal sphincter. The water at different amount of 1. 5ml, 2. 0ml, 2. 5ml and 3. Oml were respectively injected into the cuffs that could press the bowel following the inflation of the cuff. The proximal bowel was then infused with water till the occurrence of the leakage from the bowel. The maximal bowel volume and the intraintestinal pressure were recorded, respectively. The results showed that when the cuff was inflated with 2. 5ml water, the bowel-restrained pressure could reach to 155 cmH2O, and the maximal bowel volume and the intraintestinal pressure were also higher than that in either 1. 5ml or 2.0ml groups. The intraintestinal pressure was a little higher and the maximal bowel volume was similar in the 3. 0ml group comparing to that in the 2. 5ml group. No significant change was observed when the living dogs were followed up at 2,4,6 and 8 weeks after operation. It is concluded that the appropriate bowel-restrained pressure of the artificial anal sphincter can be acquired when the cuff is inflated with 2. 5ml water. The artificial anal sphincter is available for the control of fecal incontinence.

关 键 词：人工泵式括约肌 节制排便 肠管约束压 肛门失禁 

分 类 号：R657.1[医药卫生—外科学]