小儿肛门直肠压立体向量容积测量及临床意义

Vector Volume Measuring of the Anorectal Pressure and Its Clinical Applications

目的:为了测量肛门直肠高压区的长度,不同断面上各方向的压力及其压力容积,得到一个三维空间数据,对52例儿童进行测压检查,其中正常儿童30例,未手术的先天性巨结肠症患儿6例,肛门直肠畸形术后伴不同程度失禁的患儿10例,特发性慢性便秘患儿6例。方法:采用8根头端封闭并开有一侧孔的细软管组成测压管进行测定,测压管经过肛门直肠高压区时,可测到圆周上8个不同方向的连续压力曲线,经计算机处理可得出直肠高压区的压力容积。结果:正常小儿在静息时为225.4±17.2cm^3,收紧时为584.8±25.2cm^3(±s),并可绘出某一剖面的压力向量图及立体向量容积图。从而了解直肠肛门不同断面360°圆周上每隔45°的8个不同方向的压力,了解各方向肌肉活动情况,提示临床需切开的部位及范围,指导外括约肌替代术式的选择,指导术后的功能锻炼,评价手术效果及肌群恢复情况。结论:该测压法对评估肛门功能,了解病理状态及指导治疗提供了立体、动态、准确、具体的指标。

Objective:A vector volume reference is obtained by measuring the resting and the contracting pressure at different levels and lengty of the high pressure zone in the anal canal. Methods:The manometric reception cathter was made of eight blind end tubules with a side hole at the distal end of each tubule.Through the side holes measuring,pressure curves were recorded as catheter advancing at different levels.Results:The resting and contracting vector volume of normal children were 225.4±17.2cm^3 and 584.8±25.2cm^3(±s)respectively.Conclusions:The vector volume measuring is useful in evaluating the function anorectal sphincter,and may serve as an indication of further surgery and the biofeed-back training.