直肠脱垂肛管直肠功能变化的临床特征及意义

Changes of Pudendal Nerve Terminal Movement Latency and Anorectal Function in Rectal Prolapsed Patients

【目的】通过研究肛管直肠动力及阴部神经潜伏期的变化,探讨直肠脱垂患者肛管功能的异常,为临床制定治疗方式提供合理依据。【方法】回顾分析60例诊断为直肠脱垂患者水灌注肛管直肠压力数据,分析肛管静息压、肛管功能长度、肛管最大收缩压、直肠黏膜初始感觉、初始排便感觉及最大耐受阈值,并将检查结果与正常人群参数比较;其中20例患者完成盆底肌电图检查,分析阴部神经潜伏期的变化。【结果】直肠脱垂患者肛管静息压力、收缩压力均低于正常人群(P<0.05);肛管功能长度缩短(P<0.05);直肠初始感觉及初始排便阈值高于正常人群(P<0.05),直肠最大耐受阈值无明显变化;直肠脱垂患者阴部神经潜伏期延长超过2.6 ms。【结论】直肠脱垂患者肛管静息持便及收缩功能减弱,直肠黏膜敏感性下降,直肠黏膜下神经丛反应降低,阴部神经潜伏期延长。

【Objectives】To evaluate the change of anorectal function in patients with rectal prolapsed by water perfusion anorectal manometry and pelvic floor electromyography.【Methods】A total of 60 patients with rectal prolapsed were enrolled in this study,the analgesic parameters included resting sphincter pressures, squeeze sphincter pressures, length of the anal canal and rectal sensation, the results were compared with the parameters of normal population. Twenty of which completed pelvic floor electromyography examination, analyzed the changes of pudendal nerve terminal movement latency(PNTML).【Results】The resting sphincter pressures,squeeze sphincter pressures of patients were lower than the normal population; The length of anal canal was shortened; The first sensation and the first defecation threshold were higher than those of normal people, There was no significant change in the maximum tolerable threshold of rectum; pudendal nerve terminal movement latency extended more than 2.6 ms.【Conclusions】Anal resting stool and function of contraction weakened in patients of rectal prolapse, decreased sensitivity of rectal, pudendal nerve terminal movement latency extended.