老年人功能性便秘的动力学及危险因素分析

Analysis anorectal dynamics and risk factors of the elderly patients with functional constipation

目的探讨老年人功能性便秘的直肠肛门动力学特点及危险因素。方法实验组为符合罗马Ⅲ诊断标准的70例老年功能性便秘患者,对照组健康人30例。对两组人群分别进行肛门直肠测压,测量指标包括直肠及肛门静息压、肛管最大缩榨压、最大容量感觉阈值、模拟排便时肛管压。比较两组的各项压力指标,同时进行调查问卷,探讨引起便秘的可能危险因素。结果便秘组与对照组直肠及肛门静息压比较,差异无统计学意义(P>0.05);便秘组的肛门最大缩榨压、最大容量感觉阈值及模拟排便时肛管括约肌压力均高于对照组,差异有统计学意义(t值分别为:2.339、1.752、2.319,P<0.05)。利用Logistic回归分析对各种与功能性便秘有关的因素进行多因素分析,结果显示饮食因素、精神心理因素、久坐不动、排便动力学异常、药物因素以及痔疮等6种因素为最具可能性的危害因素,其OR值均>1。结论老年功能性便秘患者的直肠肛门动力学有异常改变,老年人便秘的发生与饮食因素、精神心理因素以及药物等6种因素密切相关。

Objective To investigate the anorectal dynamics and risk factors in elderly patients with functional constipation. Methods Anorectal manometry was performed in 100 elderly patients with functional constipation( according to Rome Ⅲ criteria) and 30 healthy persons were recruited as control.Measurement indicators included rectum and anal resting pressure, anal maximal squeezing pressure,maximum capacity of sensory threshold,defecating anal canal pressure. Comparing the pressure indicators in the two groups,at the same time, we investigated the possible risk factors of constipation through a questionnaire. Results There was no significant difference in the rectum and the anus resting pressure between the constipation group and the control group( P > 0. 05). The anal maximum squeezing pressure,maximum capacity of sensory thresholds and defecating pressure of anal sphincter in constipation group were higher than that in control group( P < 0. 05). Logistic regression analysis showed that the 6 factors,such as dietary factors,psychological factors,sedentary,dynamic abnormality of defecation,drug factors and hemorrhoids were the most likely to harm. Conclusions The anal dynamics in the elderly patients with functional constipation were different compared with healthy. Dietary and medication were risk factors of the elderly patients with functional constipation.