先天性巨结肠术后直肠肛管向量测压的研究

Anal sphincter function assessment of surgical Hirschsprung's disease by vectorial manometry

目的 应用直肠肛管向量测压技术评估先天性巨结肠患儿术后肛门括约肌功能。方法 利用直肠肛管向量测压技术 ,对 4 2例先天性巨结肠患儿术后及 2 1例正常儿进行肛门括约肌功能的评估。结果 根据临床症状将患儿分为污便组、便秘组和排便功能良好组。巨结肠患儿术后肛管静息压力及向量容积均显著低于正常儿 (P <0 .0 1) ,污便组的静息压力及向量容积明显低于排便功能良好组 ,对称指数无明显变化 ,14 .3%恢复了直肠肛门抑制反射。结论 先天性巨结肠患儿术后肛管最大压力及向量容积下降。直肠肛管向量测压技术是评估先天性巨结肠患儿术后肛门括约肌功能较客观全面的方法。

Objective Using vectorial manometry to assess the anal sphincter function after surgical correction of Hirschsprung's disease.Methods The anal sphincter function of 42 patients with surgical Hirschsprung's disease and 21 normal children were assessed by vectorial manometry.Results The patients were subdivided into soiling group,constipation group and good group according to the symptoms. Maximal pressure and vector volume of the patients were significantly lower than those of the normal children( P < 0.01 ). The resting maximal pressure and resting vector volume in soiling group were significantly lower than those in good group. There was no significant difference between patients and normal children concerning vector symmetry index. 14.2% patients had anorectal inhibitory reflex.Conclusions The maximal pressure and vector volume were deficient in patients after operation. The vectorial manometry can be an objective comprehensive tool for the evaluation of anal sphincter function in patients with surgical Hirschsprung's disease.