老年出口梗阻型便秘患者肛门直肠测压特点分析  

Analysis of pressure measurement characteristics of functional outlet obstruction constipation with elderly patients

作　　者：张睿 陈艳妮[1] 侯孝涛 陈浩[1] 麻琦瑶 倪敏[2] Zhang Rui;Chen Yanni;Hou Xiaotao;Chen Hao;Ma Qiyao;Ni Min(Department of Anorectal Surgery,Zhongda Hospital Southeast University(jiangbei),Nanjing 210044,China;National Center of Colorectal Disease,Nanjing Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210022,China)

机构地区：[1]东南大学附属中大医院江北院区(原大厂医院)肛肠科,南京210044 [2]南京中医药大学附属南京中医院肛肠科,210022

出　　处：《中华结直肠疾病电子杂志》2023年第2期139-144,共6页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：南京市卫生科技发展专项资金项目(YKK21218);中大医院江北院区科研育苗基金项目(JB202101Q)。

摘　　要：目的探讨老年出口梗阻型便秘(OOC)患者肛门直肠动力及直肠感知功能的特点。方法回顾性分析南京市中医院2019年6月至2020年6月期间在便秘平台收治的47例老年OOC患者及50名中青年OOC患者的肛门直肠动力及直肠感知功能资料。结果47例老年OOC患者的平均肛管静息压低于中青年OOC患者的平均肛管静息压(t=2.31,P<0.05),平均肛管舒张压也低于中青年OOC患者(t=2.63,P<0.05)。平均最大收缩压老年女性OOC患者低于老年男性OOC患者(t=2.59,P<0.05),OOC老年女性患者较OOC老年男性患者的肛门括约肌长度缩短(t=4.64,P<0.05)。老年女性OOC患者的平均肛管静息压低于中青年女性OOC患者的平均肛管静息压(t=3.54,P<0.05),平均最大收缩压老年女性OOC患者低于中青年女性OOC患者(t=2.75,P<0.05)。老年女性OOC患者中,伴有直肠前突患者的平均肛管静息压高于不伴有直肠前突患者的平均肛管静息压(t=2.55,P<0.05),平均最大收缩压伴有直肠前突患者高于不伴有直肠前突患者(t=2.46,P<0.05)。伴有会阴下降患者的平均肛管静息压高于不伴会阴下降患者(t=2.22,P<0.05),两组对比差异具有统计学意义。结论肛门括约肌的压力异常及直肠敏感性的改变是导致出口梗阻型便秘的重要因素,而出口梗阻型便秘的相关参数受到性别、年龄及是否有合并症的影响,不同年龄、性别及合并症的出口梗阻型便秘患者动力学和感觉参数各有不同。Objective To investigate the characteristics of anorectal motility and rectal perception in elderly patients with outlet obstruction constipation.Methods The data of anorectal motility and rectal perception of 47 elderly OOC patients and 50 young and middle-aged OOC patients who admitted to the constipation platform of Nanjing Hospital of Traditional Chinese Medicine from June 2019 to June 2020 were analyzed.Results The mean anal resting pressure of 47 elderly patients with OOC was lower than that in young and middle-aged patients with OOC(t=2.31,P<0.05),the average anal diastolic blood pressure was also lower than that of young and middle-aged OOC patients(t=2.63,P<0.05).The mean maximum systolic blood pressure of elderly female OOC patients was lower than that of elderly male OOC patients(t=2.59,P<0.05),the length of anal sphincter in elderly female patients with OOC was shorter than that in elderly male patients with OOC(t=4.64,P<0.05).The average resting pressure of anal canal in elderly female OOC patients was lower than that in young and middle-aged female OOC patients(t=3.54,P<0.05),the average maximum systolic blood pressure of elderly female OOC patients was lower than that of young and middle-aged female OOC patients(t=2.75,P<0.05).In elderly female OOC patients,the average resting anal pressure of patients with proctorectum was higher than that of patients without proctorectum(t=2.55,P<0.05).The average maximum systolic blood pressure was higher in patients without proctorectum(t=2.46,P<0.05),The mean anal resting pressure in patients with perineal decline was higher than that in patients without perineal decline(t=2.22,P<0.05),the difference between the two groups was statistically significant.Conclusion Anorectal motility and rectal sensory are important factors leading to outlet obstruction constipation.The related parameters of outlet obstruction constipation are affected by gender,age and comorbidities.

关 键 词：便秘 出口梗阻型便秘 肛管静息压 肛管收缩压 直肠敏感性 

分 类 号：R657.1[医药卫生—外科学]