成人盆底痉挛综合征患者直肠肛管压力的改变及综合医院焦虑/抑郁情绪测定评分的分析

Analysis of the Changes of Anorectal Pressure and Hospital Anxiety and Depression Scores of Adults with Spastic Pelvic Floor Syndrome

[目的]探讨盆底痉挛综合征（SPFS）患者肛管直肠压力的变化及其焦虑抑郁评分的高低的临床意义.[方法]选择本院确诊SPFS患者68例（试验组）,无排便功能紊乱症状健康志愿者20例（对照组）,采用肛管直肠测定仪进行动力学检查,并采用综合医院焦虑/抑郁情绪测定表进行心理状况评估,比较两组直肠肛管压力和焦虑抑郁评分.[结果]试验组患者直肠肛门抑制反射（RAIR）阈值、肛管最大自主收缩压、肛管自主收缩持续时间、排便窘迫阈值和直肠最大容量感觉阈值显著低于对照组（P〈0.05）;肛管静息压和直肠初始感觉阈值显著高于对照组（P〈0.05）,直肠静息压和初次排便感觉阈值高于对照组,但两者比较无统计学意义（P〉0.05）;焦虑评分及抑郁评分均显著高于对照组（P〈0.05）.[结论]SPFS患者存在明显的直肠感觉功能下降和盆底肌肉协调运动障碍,且存在焦虑抑郁症状,为临床诊治提供依据.

[Objective] To explore the changes of anorectal pressure and the level of anxiety and depression scores in patients with spastic pelvic floor syndrome （SPFS）. [Methods] Sixty eight SPFS patients and 20 healthy volunteers without defecation disorder in our hospital were selected as experiment group and control group, respectively. Anorectal manometry was used for the examination of anorectal motility and Hospital Anxiety and Depression Scale（HADS） was used to evaluate the mental status. The anorectal pressure and the scores of anxiety and depression were compared between two groups. [Results] The anorectal inhibitory reflex thresbold（RAIR）, maximal pressure of anal voluntary contraction, duration of anal voluntary contraction, defecation distress threshold, the rectal maximum volume threshold in SPFS group were significantly lower than those in the control group（ P 〈0. 05）. Anal resting pressure and the initial rectal sensation threshold in SPFS group were significantly higher than those in the control group（ P 〈0.05）. Rectal resting pressure and the initial defecation sensation thresholds in SPFS group were higher than those in the control group, but there was no statistical significance between two groups（ P 〉0.05）. Anxiety and depression scores in SPFS group were significantly higher than those in the control group（ P 〈0. 005）. [Conclusion] SPFS patients have obvious decreasing of rectal sensation and the disorder of coordinated motion of pelvic floor muscle, and also have anxiety and depression. It is helpful to provide the basis for clinical diagnosis and treatment.