肛肠测压在内括约肌重建术中的应用

Application of anorectal manometry in internal sphincter reconstruction

目的 :探讨自体肠平滑肌内括约肌重建术后对低位直肠癌患者肛门功能的影响。方法 :对 2 8例低位直肠癌自体肠平滑肌移植内括约肌重建患者术前、术中及术后 1～ 6个月 ,分别行肛肠测压。结果 :术后肛管静息压明显降低 (P <0 .0 1) ,直肠静息压和重建内括约肌“静息压”无明显改变 (P >0 .0 5 ) ;肛门最大收缩压和最大耐受容积较术前均明显降低 (P <0 .0 1) ,随着时间推移逐渐恢复 ,但不能恢复到术前水平 ;肛门直肠抑制反射无明显恢复 (P >0 .0 5 )。结论 :肛肠测压检查是一种安全、无创的客观检查技术 ,可对术前、术后肛肠功能细微和量化的评价 ,为术后肛肠功能恢复提供客观指标。

?Objective:To study the effect of anal function of patients with lower rectum cancer after internal sphincter reconstruction with autograft of colonic smooth muscle.Methods:Anorectal manometry was used for testing 28 patients with lower rectum cancer who under internal sphincter reconstruction before,during and 1～6 months after operation.Results:Anal canal resting pressure was greatly lowered after operation( P <0.01).No obvious significant change in rectum resting pressure and reconstruction internal sphincer “resting pressure” were observed( P >0.05).Maximum squeeze pressure and maximum tolerance of the rectum were greatly reduced( P <0.01) and restored gradually in course of time but not to normal.Restoration of rectal anal inhibitory reflex was not obvious( P >0.05).Conclusions:Anorectal manometry is a non traumatic technique,can make subtle and quantitative evaluation of anorectal function and offer an objective norm for restoration of anal function after operation.