直肠前突型便秘球囊辅助排便肛肠动力学研究  

A study of balloon-assisted defecation in constipation of anterior rectocele from the perspective of anorectal dynamics

作　　者：严金明 邱祥武 孙大刚 徐艳中 刘盼盼 蔡亮亮 YAN Jinming;QIU Xiangwu;SUN Dagang;XU Yanzhong;LIU Panpan;CAI Liangliang(Department of Radiology,Xuzhou Hospital of TCM in Jiangsu Province,Xuzhou221000,China;Department of Anorectal Surgery,Xuzhou Hospital of TCM in Jiangsu Province,Xuzhou221000,China)

机构地区：[1]江苏省徐州市中医院放射科,江苏徐州221000 [2]江苏省徐州市中医院肛肠外科,江苏徐州221000

出　　处：《中国现代医生》2020年第35期108-111,共4页China Modern Doctor

基　　金：江苏省徐州市科技局立项课题重点研发计划项目(KC19178)。

摘　　要：目的研究直肠前突型便秘球囊(球囊)辅助排便肛肠动力学。方法回顾分析本院2018年5月~2020年3月收治的28例中重度直肠前突便秘患者阴道内置入便秘球囊前、后肛肠动力学,并与6例排便正常的老年女性志愿者的肛肠动力指标比较。结果便秘球囊置入前、后及对照组肛肠动力学指标分别为直肠初始感觉容积(39.02±7.60)mL、(31.13±8.18)mL、(29.98±9.36)mL,初始排便容积(70.28±12.37)mL、(62.49±14.32)mL、(56.92±16.32)mL,最大耐受容积(163.43±19.18)mL、(148.59±18.47)mL、(142.46±23.81)mL,肛管静息压(33.87±7.48)mmHg、(39.03±9.35)mmHg、(42.16±10.34)mmHg,肛管收缩压(77.40±11.13)mmHg、(83.86±8.47)mmHg、(88.53±9.69)mmHg,肛管排便压(75.31±15.48)mmHg、(63.92±18.36)mmHg、(57.40±12.22)mmHg。球囊置入前直肠初始感觉容积、初始排便容积、最大耐受容积较球囊置入后及对照组显著增大(P<0.05);球囊置入前肛管静息压、肛管收缩压较球囊置入后及对照组显著减低(P<0.05);球囊置入后肛管排便压较置入前及对照组降低(P<0.02);球囊置入后肛肠动力指标与对照组比较,差异无统计学意义(P>0.05)。结论球囊支撑阴道后壁,恢复了正常排便解剖生理结构,改善肛肠排便动力而辅助排便,可推广应用。Objective To study balloon-assisted defecation in constipation of anterior rectocele from the perspective of anorectal dynamics.Methods From May 2018 to March 2020,the anorectal dynamics of 28 patients with moderate and severe constipation of anterior rectocele who were admitted to and treated in our hospital before and after vaginal insertion of constipation balloon were analyzed retrospectively,and were compared with the anorectal dynamics indexes of 6 elderly female volunteers with normal defecation.Results The anorectal dynamics indexes before and after the insertion of constipation balloon and in the control group were respectively(39.02±7.60)mL,(31.13±8.18)mL and(29.98±9.36)mL in terms of the rectal first sensate volume,(70.28±12.37)mL,(62.49±14.32)mL and(56.92±16.32)mL in terms of the volume of initial defecation,(163.43±19.18)mL,(148.59±18.47)mL and(142.46±23.81)mL in terms of the maximum tolerance volume,(33.87±7.48)mmHg,(39.03±9.35)mmHg and(42.16±10.34)mmHg in terms of the anal canal resting pressure,(77.40±11.13)mmHg,(83.86±8.47)mmHg and(88.53±9.69)mmHg in terms of the anal canal systolic pressure,and(75.31±15.48)mmHg,(63.92±18.36)mmHg and(57.40±12.22)mmHg in terms of the anal defecating pressure.Before the insertion of the balloon,the rectal first sensate volume,the volume of initial defecation and the maximum tolerance volume were significantly larger than those after the insertion of the balloon and of the control group(P<0.05).Before the insertion of the balloon,the anal canal resting pressure and the anal canal systolic pressure were significantly lower than that after the insertion of the balloon and of the control group(P<0.05).After the insertion of the balloon,the anal defecating pressure was lower than that before the insertion of the balloon and of the control group(P<0.02).After the insertion of the balloon,the anorectal dynamics indexes showed no significant difference from those of the control group(P>0.05).Conclusion Balloon supports the posterior wall of vagina,restore

关 键 词：便秘 直肠前突 球囊 肛肠动力学 

分 类 号：R657.1[医药卫生—外科学]