摘要
AIM To assess the role of three-dimensional endoanal ultrasound(3D-EAUS) for morphological assessment of the anal sphincter of female patients with chronic proctalgia(CP).METHODS In this unmatched case control study, 30 consecutive female patients with CP and 25 normal women(control group) were enrolled. 3D-EAUS was performed in all subjects. Thickness and length of internal anal sphincter(IAS), thickness of puborectalis muscle(PR), length of the external anal sphincter(EAS) plus PR, and puborectalis angle were measured and compared between the two groups.RESULTS Patients with CP had significantly shorter IAS lengthand greater PR thickness, as compared to those in normal individuals(26.28 ± 3.59 mm vs 28.87 ± 4.84 mm, P < 0.05 and 9.67 ± 1.57 mm vs 8.85 ± 0.97 mm, P < 0.05, respectively). No significant betweengroup differences were observed with respect to IAS thickness and the EAS plus PR length(P > 0.05). Puborectalis angle in the CP group was significantly decreased, both in resting(88.23°± 1.81° vs 89.94°± 2.07° in control group, P < 0.05) and straining(88.47°± 3.32° vs 90.72°± 1.87° in control group, P < 0.05) phases, which suggest the presence of paradoxical contraction of PR in patients with CP. In the CP group, no significant difference in puborectalis angle was observed between the resting and straining phases(88.23°± 1.81° vs 88.47°± 3.32° respectively, P > 0.05).CONCLUSION The association of greater PR thickness and paradoxical contraction of PR with CP suggest their potential value as markers of CP.
AIM To assess the role of three-dimensional endoanal ultrasound (3D-EAUS) for morphological assessment of the anal sphincter of female patients with chronic proctalgia (CP). METHODS In this unmatched case control study, 30 consecutive female patients with CP and 25 normal women (control group) were enrolled. 3D-EAUS was performed in all subjects. Thickness and length of internal anal sphincter (IAS), thickness of puborectalis muscle (PR), length of the external anal sphincter (EAS) plus PR, and puborectalis angle were measured and compared between the two groups. RESULTS Patients with CP had significantly shorter IAS length and greater PR thickness, as compared to those in normal individuals (26.28 +/- 3.59 mm vs 28.87 +/- 4.84 mm, P < 0.05 and 9.67 +/- 1.57 mm vs 8.85 +/- 0.97 mm, P < 0.05, respectively). No significant between-group differences were observed with respect to IAS thickness and the EAS plus PR length (P > 0.05). Puborectalis angle in the CP group was significantly decreased, both in resting (88.23 degrees +/- 1.81 degrees vs 89.94 degrees +/- 2.07 degrees in control group, P < 0.05) and straining (88.47 degrees +/- 3.32 degrees vs 90.72 degrees +/- 1.87 degrees in control group, P < 0.05) phases, which suggest the presence of paradoxical contraction of PR in patients with CP. In the CP group, no significant difference in puborectalis angle was observed between the resting and straining phases (88.23 degrees +/- 1.81 degrees vs 88.47 degrees +/- 3.32 degrees respectively, P > 0.05). CONCLUSION The association of greater PR thickness and paradoxical contraction of PR with CP suggest their potential value as markers of CP.
基金
Supported by the State administration of Traditional Secretary and the nanjing health Bureau,no.YKK12142
