结肠通过时间和盆底肌电图检查对功能性便秘分型的临床意义

Clinical Significance of Functional Constipation Categorization through Detection of Colonic Transit Time and Pelvic Floor Electromyography

背景:功能性便秘是一种常见的胃肠道功能性疾病,随着社会生活方式和饮食结构等的改变,其发病率正逐年增高,并向年轻化发展。正确的分型对该病治疗方法的选择具有指导意义。目的:探讨结肠通过时间和盆底肌电图检查对功能性便秘分型的临床意义。方法:选择符合功能性便秘罗马Ⅱ诊断标准的患者32例,病史6个月～30年不等。应用不透X线的标志物进行结肠通过时间检查,计算传输指数(TI)和结肠排出率;同时结合盆底肌电图检查观察是否存在盆底肌与腹部肌群的矛盾运动。结果:结肠通过时间检查显示20例患者为出口梗阻型便秘,12例为慢传输型便秘。盆底肌电图检查显示出口梗阻型便秘患者均存在不同程度的盆底肌与腹部肌群的矛盾运动,慢传输型便秘患者中有4例存在盆底肌与腹部肌群的矛盾运动。结论:采用结肠通过时间和盆底肌电图检查可对功能性便秘作出分型,方法简便易行且无痛苦。

Background:Functional constipation is a common functional gastrointestinal disorder.With the changes of social life style and dietary composition,its incidence increases year by year,and the age of patients are much younger than before.Correct categorization would be useful in guiding the treatment of functional constipation.Aims: To appraise the clinical sig-nificance of colonic transit time examination and pelvic floor electromyography in correct categorization of functional con-stipation.Methods: Thirty-two cases of functional constipation concordant with RomeⅡdiagnostic criteria with a course of history from6months to30years were enrolled.Radio-opaque markers were used for detection of colonic transit time,the transit index(TI)and colonic evacuation rate were calculated;Pelvic floor electromyography was used in combination to ob-serve whether there existed any paradoxical movement between pelvic floor muscle and belly muscles.Results: Colonic transit time shown in20patients was of outlet obstruction constipation,12patients were of slow transit type.In the outlet obstruction type,the pelvic floor electromyography showed varying degrees of paradoxical movement between pelvic floor muscle and belly muscles,whereas in the slow transit type,only4cases showed paradoxical movement between pelvic floor muscle and belly muscles.Conclusions:Colonic transit time examination and pelvic floor electromyography can provide cor-rect categorization of functional constipation,which are simple and feasible without induction of pain.