肠易激综合征患者直肠感觉功能和肛肠动力学的研究

Study of rectal sensation functions and anorectal dynamics in the patients with irritable bowel syndrome

目的 探讨肠易激综合征 (IBS)患者直肠的感觉功能和直肠肛门括约肌的动力学特征。方法 将34例IBS患者随机分为两组 :腹泻组和便秘组各 17例 ,采用PCPolygrafHR高分辨多道胃肠功能测定仪测定 34例IBS患者和 12例健康对照的肛门直肠压力、直肠容量感知、疼痛阈值、耐受阈值等指标。结果 腹泻组和便秘组IBS患者的直肠静息压、肛管括约肌静息压、最大缩窄压及肛管长度与健康对照组无显著性差异 ,初始感觉阈值、疼痛阈值、排便阈值 ,IBS腹泻组均低于正常对照组 ,而IBS便秘组均高于正常对照组。排便时IBS便秘组患者的肛管松弛压高于正常对照组。结论 IBS患者排便功能和直肠感觉功能存在异常。

Objective: To study the rectal sensation functions and the feature of anorectal dynamics in patients with irritable bowelsyndrome(IBS). Methods: Thirty-four patients suffered from IBS were randomly divided by two groups: diarrhea group(17 cases) and constipation group(17 cases). Multichannel and single-balloon anorectal function detector of PC Polygraf HR were applied in 34 cases patients with IBS and 12 cases normal subjects for measurement of parameters such as anorectal pressure, rectal sensation volume thresholds, rectal defecation volume thresholds, rectal maximum tolerable volume thresholds.Results: There are no differences in rectal resting pressure ,anal resting pressure ,anorectal sphincteric squeezing pressure, the length of high pressure zone between the patients with IBS and normal subjects. But rectal sensation volume thresholds, rectal defecation volume thresholds, rectal maximum tolerable volume thresholds were higher in constipation group of IBS than that in normal subjects, and lower in diarrhea group of lBS than that in normal subjects. The relaxation pressue of sphincter during defecation in constipation group of IBS were higher than that in normal subjects.Conclusions: Rectal sensation functions to irritation and defecation functions in patiens with IBS were abnormal.