直肠前突患者高分辨率肛门直肠测压特征研究  

Analysis of anorectal motility of patients with rectocele by high-resolution anorectal manometry

作　　者：于秋磊 艾琦[2] 支宇[3] 翁瑜 翁文采[2] YU Qiulei;AI Qi;ZHI Yu;WENG Yu;WENG Wencai(Medical college of Dalian university, Liaoning 116201;Radiology department, Xinhua affiliated hospital of Dalian university, Liaoning 116021;Pelvic floor center, Xinhua affiliated hospital of Dalian university, Liaoning 116021;College of Light industry and food engineering of Guangxi university, Guangxi 530004, China)

机构地区：[1]大连大学医学院,116021 [2]大连大学附属新华医院放射线科,116021 [3]大连大学附属新华医院盆底中心,116021 [4]广西大学轻工与食品工程学院,530004

出　　处：《中国老年保健医学》2022年第2期44-47,共4页Chinese Journal of Geriatric Care

摘　　要：目的探讨直肠前突患者肛门直肠动力的表现,尝试了解直肠前突患者肛门直肠动力的特征。方法采用回顾性研究,收集2018年3月至2021年5月大连大学附属新华医院盆底疾病中心确诊的功能性便秘女性患者86例,所有患者均行X线动态排粪造影检查,观察并记录患者直肠前突程度。之后,采用肛门直肠测压仪进行动力学检查,测压观察指标包括动态直肠压力指标及直肠感觉功能指标两方面。直肠压力指标包括肛管静息压、直肠压力、肛管残余压及最大缩榨压;直肠感觉功能指标包括直肠初始感觉阈值、初始便意阈值、最大容量感觉阈值和直肠肛门抑制反射。结果不同程度直肠前突患者肛管静息压及肛管残余压指标组间有显著差异(P<0.05),其中无直肠前突组肛管静息压显著低于轻度直肠前突组(P<0.05)、中度直肠前突组(P<0.05)及重度直肠前突组(P<0.05)。无直肠前突组肛管残余压显著低于重度直肠前突组(P<0.05)。其他特征未见明显差异(P<0.05)。结论患有直肠前突的患者肛管静息压显著增加,随着病程的进展重度直肠前突患者肛管残余压亦会增加,提示部分直肠前突的成因可能与肛管括约肌压力的增加有关。Objective To investigate the performance of anorectal motility in patients with rectocele and try to understand the characteristics of anorectal motility in patients with rectocele.Methods A Retrospective study was conducted to collect 86 female patients diagnosed with functional constipation in the Pelvic Floor Disease Center of Xinhua Hospital Affiliated to Dalian University from March 2018 to May 2021.All patients underwent X-ray dynamic defecography.The degree of rectocele was observed and recorded.Afterwards,anorectal manometry was used for kinetic examination,and the manometry observation indicators included dynamic rectal pressure indicators and rectal sensory function indicators.Rectal pressure indicators include anal canal resting pressure,rectal pressure,anal canal residual pressure and maximum constriction pressure;rectal sensory function indicators include rectal initial sensory threshold,initial convenience threshold,maximum volume sensory threshold and anorectal inhibitory reflex.Results There were significant differences in anal canal resting pressure and anal canal residual pressure indexes among patients with different degrees of rectocele(P<0.05),in which the anal canal resting pressure in the group without rectocele was significantly lower than that in the mild rectocele group(P<0.05),moderate rectocele group(P<0.05)and severe rectocele group(P<0.05).The residual pressure of anal canal in the group without prolapse was significantly lower than that in the group with severe prolapse(P<0.05).There was no significant difference in other characteristics(P<0.05).Conclusion The resting pressure of the anal canal was significantly increased in patients with rectocele,and the residual pressure of the anal canal was also increased in patients with severe rectocele with the progression of the disease,suggesting that the cause of partial rectocele may be related to the increase in anal sphincter pressure.

关 键 词：X线排粪造影 直肠前突 高分辨率肛门直肠测压 

分 类 号：R73[医药卫生—肿瘤]