中老年便秘患者肛门直肠功能的变化特征

Characteristics of Anorectal Function in Middle-Elderly Patients with Constipation

目的:探究中老年便秘患者肛门直肠功能的异同点。方法:选取41例功能性便秘(FC)患者,26例便秘型肠易激综合征(IBS-C)患者及19例无症状健康受试者,经肛门直肠测压检查,比较FC、IBS-C患者各参数的变化。结果:(1)FC患者直肠肛门抑制反射最小直肠诱发容量、直肠扩张初始感觉阈值增加(P<0.05),模拟排便肛管松弛率降低(P<0.05),矛盾收缩运动增加(P<0.01),排空功能降低。(2)IBS-C患者直肠扩张初始感觉阈值、直肠静息压、肛管静息压增加(P<0.05),模拟排便肛管松弛率降低(P<0.05),矛盾收缩运动增加(P<0.01),排空功能降低。结论:中老年FC、IBS-C患者肛门直肠功能与健康人不同。肛门直肠测压检查无助于鉴别中老年FC与IBS-C。

Objective:To characterize the anorectal function in middle-elderly patients with constipation.Methods:Anorectal manometry was performed in 41 patients with functional constipation(FC),26 patients with constipation-predominant irritable bowel syndrome(IBS-C)and 19 healthy controls.Their rectal anal inhibitory reflex,anal sphincter pressure,rectal sensation and emptying function were compared.Results:(1)Compared with controls,FC patients showed increases in minimum threshold to evoke rectal anal inhibitory reflex,initial sensory threshold in rectal distension(P<0.05)and contradictory contraction in defecation(P<0.01),and decreases in anal sphincter relaxation rate(P<0.05)and emptying function.(2)Compared with controls,IBS-C patients showed increases in initial sensory threshold in rectal distension,resting rectal pressure,resting anal pressure(P<0.05)and contradictory contraction in defecation(P<0.01),and decreases in anal sphincter relaxation rate(P<0.05)and emptying function.Conclusion:Middleelderly patients with FC and IBS-C showed significant difference from controls in anorectal function.However,anorectal manometry may make no contribution to distinguish between FC and IBS-C.