排便造影动态观察盆底形态对功能性出口梗阻所致便秘的诊断价值

Application of Defecography in Dynamic Observation of the Pelvic Floor in Resultant Constipation by the Obstruction of the Functional Outlet

目的 探讨仅在排便过程中才表现出来的直肠、肛管的一系列功能性异常。资料与方法 通过钡灌肠 ,于坐位进行排便 ,动态下透视、点片。结果 5 2 0例中 ,发现直肠黏膜脱垂、套叠 4 16例 ,直肠前突 2 81例 ,盆底及会阴下降 2 2 9例 ,盆底肌失弛缓综合征 170例 ,盆底疝 113例 ,骶直分离等其他盆底病变 4 3例。合并上述两项以上病变者多见。结论 排便造影动态观察盆底形态是较传统的钡灌肠、临床指诊、内镜检查更为敏感可靠的方法 。

Objective To investigate the functional abnormality of the rectum and anus during defecation. Materials and Methods During defecation in seat position, pelvic floor was dynamically observed by fluoroscopy and spot film with barium enema. Results In 520 cases with barium enema, the prolapse of rectal mucosa and rectum intussusception were found in 416, anterior rectocele in 281, descending pelvic floor and perineum in 229, muscle achalasia of pelvic floor in 170, hernia of pelvic floor in 113, and other pelvic floor diseases such as separation of sacrum and rectum in 43. The combination of the above two diseases was mostly found. Conclusion Defecography with barium enema is more sensitive than conventional barium enema, digital examination and endoscopy in dynamic observation of pelvic floor. And it can provide reliable information for the diagnosis of resultant constipation by the rectum and anus diseases such as the obstruction of functional outlet and surgery of choice.