便秘型肠易激综合征患者肛门直肠感觉及动力学变化的临床研究

Clinical study of anorectal sensation and dynamics changes in irritable bowel syndrome with constipation

目的探讨便秘型肠易激综合征(IBS-C)患者的肛门动力学及肛门直肠感觉功能变化及其盆底肌电压情况。方法选择2014年12月1日至2017年12月1日期间中国人民解放军联勤保障部队942医院消化内科收治的IBS-C患者36例(IBS-C组)及健康自愿者28例(对照组),分别采用ZJ-D3型肛肠压力检测仪和生物刺激反馈仪检测2组受试者的直肠肛管压力(肛管静息压、直肠静息压、肛管直肠压差、肛管高压带长度、直肠感觉阈值及直肠顺应性)和盆底肌电压变化并进行比较。结果 IBS-C组的直肠静息压和肛管静息压分别与对照组比较差异均无统计学意义(P>0.05),但IBS-C组的肛管直肠压差明显高于对照组(t=4.371,P=0.017),IBS-C组的肛管高压带长度明显长于对照组(t=6.180,P=0.042)。IBS-C组盆底肌的最大肌电压、最小肌电压及电压频率均明显高于对照组(t=3.386,P=0.031;t=5.763,P=0.042;t=8.410,P<0.001)。结论肛门直肠动力学和直肠感觉功能异常可能是IBS-C的重要病因之一,IBS-C可能存在异常的盆底肌肌电压变化。

Objective To investigate changes in anal dynamics and anorectal sensory function in patients with irritable bowel syndrome with constipation(IBS-C) and detect its status of basin's myoelectric pressure. Methods Thirty-six patients with IBS-C(IBS-C group) and 28 healthy volunteers(control group) were collected. The rectal-anal canal pressure and the change of the basin's myoelectric status were detected by the ZJ-D3 gastrointestinal motility tester and bio-stimulus feedback instrument, respectively. The anal canal resting pressure, rectal resting pressure, anorectal pressure difference, length of anal canal high pressure area, rectal sensation threshold, rectal compliance, and basin's myoelectric voltage were compared between these two groups. Results There were no significant differences in the rectal resting pressure and anal canal resting pressure between the IBS-C group and the control group(t=-2.312, P=0.851;t=-5.464, P=0.283), but the difference value of anorectal pressure of the IBS-C group was significantly higher than that of the control group(t=4.371, P=0.017), and the length of the anal canal hypertension area in the IBS-C group was significantly longer than that of the control group(t=6.180, P=0.042). The maximal and minimum basin's myoelectric voltage and frequency of the basin's myoelectric voltage in the IBS-C group were significantly higher than those in the control group(t=3.386, P=0.031;t=5.763, P=0.042;t=8.410, P<0.001). Conclusion Anorectal dynamics and rectal sensory dysfunction are one of important causes of IBS-C, it might be existed abnormal changes in basin's myoelectric voltage.