基于"仿真造影剂"指导慢性便秘患者不同体位和角度下排粪治疗优化的影像研究  

Image study on the optimization of defecation treatment in patients with chronic constipation under different positions and angles guided by"simulated contrast agent"

作　　者：吴晓伟[1] 李华[1] 单超 石银虎 郭雪菲 Wu Xiaowei;Li Hua;Shan Chao;Shi Yinhu;Guo Xuefei(Department of Radiology,Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院放射科,邯郸056001

出　　处：《中国医师进修杂志》2023年第11期1009-1014,共6页Chinese Journal of Postgraduates of Medicine

基　　金：邯郸市科学技术研究与发展计划项目(22422083041ZC)。

摘　　要：目的研究基于"仿真造影剂"指导慢性便秘患者不同体位和角度下排粪治疗优化的影像学差异。方法回顾性分析2020年4月至2022年4月邯郸市中心医院78例慢性便秘患者的临床资料。其中,采用90°的常规排粪造影检查体位26例(常规体位组),60°~89°排粪造影检查体位26例(61°~89°体位组),30°~59°亚洲蹲排粪造影检查体位26例(亚洲蹲体位组)。比较三组患者的排粪造影结果、便秘评分和排粪造影异常情况。结果61°~89°体位组和亚洲蹲体位组直肠前突、直肠内套叠、会阴下降距离明显小于常规体位组[(2.71±0.25)和(2.11±0.66)mm比(3.06±0.23)mm、(9.06±1.78)和(8.55±2.81)mm比(10.22±1.59)mm、(11.52±2.70)和(10.52±2.93)mm比(12.52±3.43)mm],亚洲蹲体位组明显小于61°~89°体位组,差异有统计学意义(P<0.01);61°~89°体位组和亚洲蹲体位组力排状态肛直角和力排状态肛直角开大角度明显大于常规体位组[(120.47±3.35)°和(122.44±3.33)°比(118.19±3.66)°、(19.99±3.47)°和(20.25±2.69)°比(18.77±2.79)°],亚洲蹲体位组明显大于61°~89°体位组,差异有统计学意义(P<0.01);三组静息状态肛直角比较差异无统计学意义(P>0.05)。61°~89°体位组和亚洲蹲体位组Longo出口梗阻型便秘评分、Wexner便秘评分和便秘严重程度评分明显小于常规体位组[(14.41±2.66)和(12.24±3.49)分比(16.64±3.37)分、(13.79±2.74)和(12.83±3.08)分比(15.76±3.56)分、(13.34±2.72)和(12.31±2.52)分比(16.08±3.57)分],亚洲蹲体位组明显小于61°~89°体位组,差异有统计学意义(P<0.01)。常规体位组、61°~89°体位组和亚洲蹲体位组排粪造影异常情况检出率分别为96.15%(25/26)、84.62%(22/26)和69.23%(18/26),三组比较差异有统计学意义(P<0.05);其中,亚洲蹲体位组明显低于常规体位组,差异有统计学意义(P<0.05)。结论基于"仿真造影剂"指导的慢性便秘患者采取亚洲蹲体位,其排粪功能以及影像学指标明显�Objective To study the optimization of defecation treatment in patients with chronic constipation under different positions and angles by"simulation contrast agent".Methods The clinical data of 78 patients with chronic constipation in Handan Central Hospital from April 2020 to April 2022 were retrospectively analyzed.Among them,26 patients were examined by 90°conventional defecography position(conventional position group),26 patients by 60°to 89°defecography position(61°to 89°position group),and 26 patients by 30°to 59°Asian squat defecography position(Asian squat position group).The results of defecography,constipation score and defecography abnormality were compared among the three groups.Results The encysted rectum,internal rectal intussusception and descending distance of perineum in 61°to 89°position group and Asian squat position group were significantly lower than those in conventional position group:(2.71±0.25)and(2.11±0.66)mm vs.(3.06±0.23)mm,(9.06±1.78)and(8.55±2.81)mm vs.(10.22±1.59)mm,(11.52±2.70)and(10.52±2.93)mm vs.(12.52±3.43)mm,the indexes in Asian squat position group were significantly lower than those in 61°to 89°position group,and there were statistical differences(P<0.01);the anal right angle and the anal right angle in force discharge state in 61°to 89°position group and Asian squat position group were significantly higher than those in conventional position group:(120.47±3.35)°and(122.44±3.33)°vs.(118.19±3.66)°,(19.99±3.47)°and(20.25±2.69)°vs.(18.77±2.79)°,the indexes in Asian squat position group were significantly higher than those in 61°to 89°position group,and there were statistical differences(P<0.01);there was no statistical difference in resting anal right angle among the three groups(P>0.05).The Longo outlet obstructive constipation score,Wexner constipation score and constipation severity score in 61°to 89°position group and Asian squat position group were significantly lower than those in conventional position group:(14.41±2.66)and(12.24±3.4

关 键 词：便秘 排便 仿真造影剂 体位 

分 类 号：R574.62[医药卫生—消化系统]