肛门直肠测压在盆底功能障碍型便秘患者中应用的临床价值

Value of Anorectal Manometry in Patients with Pelvic Floor Dysfunction Constipation

目的探讨肛门直肠测压在盆底功能障碍型便秘患者中应用的临床价值。方法对2017年1月至2018年2月诊治的功能性便秘患者进行肛门直肠测压,并记录直肠静息压、肛管静息压、缩榨压、排便压、力排时肛管剩余压等直肠肛管动力学参数,同时记录感觉阈值、初始便意感、持续便意感、最大耐受容量等直肠排便感觉参数。根据测压结果,随机选取30例盆底功能障碍型便秘患者为研究组,30例非盆底功能障碍型便秘患者为对照组。结果研究组肛管静息压、缩榨压、排便压、力排时肛管剩余压、感觉阈值、初始便意感等较对照组增高(P<0.01),2组直肠静息压、持续便意感、最大耐受容量比较差异无统计学意义(P>0.05)。结论盆底功能障碍型便秘患者存在肛门直肠动力异常和排便感觉异常。肛门直肠测压简单方便,对盆底功能障碍型便秘患者可以作出初步诊断,为下一步生物反馈治疗提供有力依据。

Objective To evaluate the value of anorectal manometry in pelvic floor dysfunction constipation. Methods Anorectal manometry was performed in patients with functional constipation to record the rectal resting pressure,anorectal resting pressure,maximum squeezing pressure,defecation pressure and residual pressure between January 2017 and February 2018.Furthermore,sensory threshold,first sensation volume,continuous sensation volume and maximum tolerable volume were recorded.According to the results,30 patients with pelvic floor dysfunction constipation were assigned into the study group,and 30 patients with non-pelvic floor dysfunction constipation were selected as the control group. Results Compared with control group,anorectal resting pressure,maximum squeezing pressure,defecation pressure,anorectal residual pressure,sensory threshold and first sensation volume significantly increased in study group（ P 〈0.01）.There were no significant differences in rectal resting pressure,continuous sensation volume and maximum tolerable volume between the two groups（ P 〉0.05）. Conclusion Patients with pelvic floor dysfunction constipation had abnormalities in anorectal motility and sensory function.As a simple and convenient method,anorectal manometry can be used to make a preliminary diagnosis for pelvic floor dysfunction constipation and provides a basis for subsequent biofeedback treatment.