便秘患者肛管直肠动力变化特征及与临床症状的相关性  

Characteristics of anorectal dynamic changes in constipation patients and their correlation with clinical symptoms

作　　者：李丽[1] 罗玲花 钟丽 林宏城[1] LI Li;LUO Linghua;ZHONG Li;LIN Hongcheng(The Sixth Affiliated Hospital,Sun Yat-sen Univer-sity,Guangdong Provincial Key Laboratory of Colorectaland Pelvic Floor Diseases,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院,广东省结直肠盆底疾病研究重点实验室,广州510655

出　　处：《实用医学杂志》2020年第23期3227-3230,3236,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金面上项目(编号:81973847)。

摘　　要：目的通过研究便秘患者肛管直肠各动力学指标的变化及与临床症状的相关性,探讨肛管直肠动力学检查对便秘患者的临床诊断意义。方法回顾性分析187例临床诊断为便秘的患者资料,包括3D高分辨肛管直肠压力测定所得到的直肠⁃肛管压力差、肛管松弛率、球囊排出时间以及Knowles⁃Eccersley⁃Scott(KESS)便秘症状评分,将直肠⁃肛管压力差、肛管松弛率、球囊排出时间与各便秘症状评分进行相关性比较分析。结果括约肌松弛率及平均松弛率均小于20%,直肠肛管压力差均为负值,肛管松弛率、球囊排出时间与各临床症状评分未发现明显相关性(P>0.05),直肠⁃肛管压力差与临床症状总分呈现负相关(相关分析系数(P=0.006,rs=-0.212),回归分析系数(F=4.229,P=0.041))。结论便秘患者肛管松弛率、球囊排出时间与临床症状的轻重无明显的相关性,直肠肛管压力差与临床症状之间呈现出负相关,压力差越大,KESS评分越低,临床症状越轻,即是腹压越大,肛门残余压越小,便秘症状越轻。Objective To investigate the clinical significance of anorectal dynamic examination in patients with constipation by studying the changes of anorectal dynamic indexes and their correlation with clinical symptoms.Methods Retrospective analysis of 187 patients diagnosed with constipation,including 3 D high reso⁃lution anorectal pressure measurement obtained by the Anorectal pressure gradient,Relaxation rate of sphincter,Balloon extraction time and Knowles⁃Eccersley⁃Scott(KESS)constipation symptoms score,the Anorectal pressure gradient,Relaxation rate of sphincter,Balloon extraction time and constipation symptoms score were compared and analyzed.Results The relaxation rate of sphincter and the average relaxation rate were less than 20%respectively,Anorectal pressure gradient was negative,There was no significant correlation between the relaxation rate of sphinc⁃ter and the time of balloon extraction(P>0.05),There was a negative correlation between Anorectal pressure gradient and total clinical symptoms(Correlation coefficient P=0.006,rs=-0.212,Regression coefficient F=4.229,P=0.041).Conclusion The relaxation rate of sphincter,balloon extraction time and the severity of clini⁃cal symptoms are not significantly correlated.Anorectal pressure gradient and clinical symptoms show a negative correlation.If the Anorectal pressure gradient is greater,the KESS score is lower,the clinical symptoms is lighter,which means the greater the abdominal pressure,the smaller the anal residual pressure,the lighter the constipa⁃tion symptoms.

关 键 词：肛管直肠压力测定 直肠⁃肛管压力差 肛管松弛率 球囊排出时间 

分 类 号：R574.63[医药卫生—消化系统]