功能性便秘患者肛管直肠测压不同检查体位研究

Effect of Different Postures on High Resolution Anorectal Manometry in Patients with Functional Constipation

目的探讨不同检查体位对高分辨率肛管直肠测压各参数的影响。方法应用高分辨率肛管直肠测压技术,对20名健康志愿者及20例功能性便秘患者在左侧卧位及坐位时进行检查,观察比较2种体位受试者肛管静息压、肛门括约肌高压带长度、肛管最大收缩压、不协调性模拟排便比例、初始感觉阈值、初始排便感阈值、急迫排便感阈值、最大耐受量等参数的差异。结果不同体位健康志愿者肛管直肠测压各参数经比较,差异均无统计学意义(P>0.05)。功能性便秘患者坐位不协调性模拟排便比例低于左侧卧位(P<0.05),其他肛管直肠测压参数的比较差异均无统计学意义(P>0.05)。结论左侧卧位和坐位对高分辨率肛管直肠测压各参数有较好的一致性,功能性便秘患者可采取坐位检查且该体位更符合排便生理。

Objective To investigate the effects of different postures on high resolution anorectal manometry （HRAM） technology. Methods The anorectal motility parameters of left lateral position and sitting positions were monitored among twenty healthy volunteers and twenty patients with functional constipation by HRAM. The anal sphincter resting pressure, high-pressure zone length, maximal squeeze pressure, dyssynergic simulated defecation, first sensation threshold, desire to defecate threshold, urge to defecate threshold and the maximum tolerated threshold in both positions were recorded. Results There was no statistical difference between anal manometric measurements of the left lateral and seated examining positions （ P〉0.05）. Rate of dyssynergic simulated defecation of the left lateral position was higher than that of the seated examining position （ P〈0.05）, and other analrectal manometric measurements showed no statistically differences between the two examining positions （P〉0.05）. Conclusion The anorectal motility parameters of the left lateral position and sitting position match well and the sitting position is recommended to patients with constipation.