胃肠电图联合肛门直肠测压、球囊逼出试验在功能性便秘分型诊断的价值探讨  

Value of Gastrointestinal Electrogram Combined with Anorectal Manometry and Balloon Expulsion Test in the Classification and Diagnosis of Functional Constipation

作　　者：许丽园 张奕秉 金捷 袁渝萍 李秦帆 金健威 XU Liyuan;ZHANG Yibing;JIN Jie;YUAN Yuping;LI Qinfan;JIN Jianwei(Wenzhou Central Hospital,Zhejiang 325400,China)

机构地区：[1]温州市中心医院,浙江温州325400

出　　处：《浙江医学教育》2021年第6期32-35,共4页Zhejiang Medical Education

摘　　要：目的:初步探讨不同亚型功能性便秘的胃肠电生理活动特点,以及胃肠电图联合肛门直肠测压、球囊逼出试验在辅助功能性便秘分型诊断中的价值。方法:回顾性分析2020年10月至2021年2月42例就诊于我院的功能性便秘患者,比较慢传输型便秘和排便障碍型便秘胃肠电生理活动参数的差异;评估胃肠电图、肛门直肠测压和球囊逼出试验联合诊断功能性便秘亚型的准确性。结果:排便障碍型组20例,慢传输型组15例和混合型7例。慢传输型便秘组胃餐前平均幅值小于排便障碍型便秘组(P<0.05);慢传输型便秘组肠餐后平均幅值小于排便障碍型便秘组(P<0.05);排便障碍型便秘组肠餐后胃肠电节律紊乱百分比低于慢传输型便秘组(P<0.05);排便障碍型便秘组肠餐后/餐前功率比大于慢传输型便秘组(P<0.05)。胃肠电图联合肛门直肠测压、球囊逼出试验诊断功能性便秘亚型价值高于胃肠电图。结论:胃肠电图胃餐前平均幅值低和肠餐后平均幅值低可能提示慢传输型便秘;肠餐后胃肠电节律紊乱百分比低和餐后/餐前功率比高可能提示排便障碍型便秘。胃肠电图联合肛门直肠测压、球囊逼出试验有助于区分功能性便秘的慢传输型与排便障碍型,对指导临床诊治具有一定的应用价值。[Objective]To investigate the characteristics of gastrointestinal electrophysiological activity in different subtypes of functional constipation,and the value of gastrointestinal electrogram combined with anorectal manometry and balloon expulsion test in assisting the classification and diagnosis of functional constipation.[Method]A total of 42 patients with functional constipation who visited our hospital from October 2020 to February 2021 were retrospectively analyzed to compare the differences in gastrointestinal electrophysiological activity parameters between slow transit constipation and defecation disorder constipation;the accuracy of combined diagnosis of functional constipation subtypes by gastrointestinal electrogram,anorectal manometry,and balloon expulsion test was assessed.[Result]There were 20 cases of defecation disorder,15 cases of slow transit type and 7 cases of mixed type.The mean amplitude before gastric meal in the slow transit constipation group was less than that in the defecation disorder constipation group(P<0.05).The mean amplitude after intestinal meal in the slow transit constipation group was less than that in the defecation disorder constipation group(P<0.05).The percentage of gastrointestinal electrical dysrhythmia after intestinal meal in the defecation disorder constipation group was lower than that in the slow transit constipation group(P<0.05)The postprandial/preprandial power ratio in the defecation disorder constipation group was greater than that in the slow transit constipation group(P<0.05).Gastrointestinal electrogram combined with anorectal manometry and balloon expulsion test was more valuable than gastrointestinal electrogram only in the diagnosis of functional constipation subtypes.[Conclusion]Low preprandial mean amplitude and low postprandial mean amplitude of gastrointestinal electromyography may indicate slow transit constipation,and low percentage of gastrointestinal electrical dysrhythmia and high power ratio after intestinal meal may indicate defecation disorder

关 键 词：功能性便秘 胃肠电图 肛门直肠测压 诊断 

分 类 号：R473.5[医药卫生—护理学]