排粪造影对女性出口梗阻型便秘的临床意义

Clinical Significance of Defecography in Diagnosis of Obstructive Constipation in Women

目的:探讨排粪造影应用于女性出口梗阻型便秘的诊断价值。方法:选择100例确诊出口梗阻型便秘的女性患者作为研究组,100例无便秘主诉的健康女性作为对照组,拍摄两组受试者在排粪过程中静坐、提肛、强忍、力排及力排后的直肠侧位X片,测量肛直角、肛上距、肛管长度、乙耻距等指标,观察100例出口梗阻型便秘的女性患者各型出口梗阻便秘所占的比例,比较两组受试女性在排粪中直肠角与肛上距的差异。结果:出口梗阻型便秘的女性患者年龄集中于45~59岁,有53人(53.0%);排便造影异常主要为直肠套叠(97.0%)、直肠前突(94.0%)和会阴下降综合征(92.0%),各造影异常所占比例比较,差异有统计学意义(χ~2=478.15,P=0.00);在力排状态下,与对照组比较,研究组的肛直角明显增大,肛上距明显缩小,差异有统计学意义(P<0.05)。结论:排粪造影可显示出口梗阻型便秘的女性排便状态下肛上距、肛直角等指标的变化,排粪造影技术对诊断女性出口梗阻型便秘有一定价值。

Objective： To understand the value of defecation angiography in diagnosis of obstructive constipation in female patients. Methods： One hundred female patients with obstructive constipation were chosen as research group （group R） and received defecation treatment. The control group （group C） included 100 healthy women without constipation complaint. The rectum side X-ray pictures of the objects in the 2 groups were taking during the defection process including the situation of sitting stilly, levator ani,forbearance,force and after the force. In the same time, indexes as anus right angle, DU- AC,anal length, and distance between sigmoid and pubis were measured. Proportions of different types of obstructive constipation among patients of group R were observed and the differences of anus right angle and DUAC during defecation between objects in the 2 groups were compared. Results： There were 53 obstructive constipation female patients in group R （53%）, and their age was concentrated in the range of 45-59. The main abnormalities showed by X-ray were rectal plexus （97.0%） , rectocele （94.0%）, and perineal descending syndrome （92.0%）. The differences of proportions of dfferent types of abnomalities were statistically significant （.g2 =478.15 ,P =0.00）. When forced, in group R, the anus right angle was significantly bigger, and DUAC was significantly smaller than those in group C （P 〈 0.05 ）. Conclusions： Defecography could show changes of anus right angle and DUAC in fe- male patients with obstructive constipation, and has some value in diagnosis of obstructive constipation in female.