慢性特发性便秘患者肛门直肠的动力改变

Changes of anorectal dynamics in patients with chronic idiopathic constipation

目的 测定慢性特发性便秘患者肛门直肠压力 ,探讨肛门直肠动力障碍在便秘发病机制中的作用。方法 采用美国Sandhill公司生产的BioLAB动力学参数监测系统及固态压力传感器导管 ,对 40例CIC患者进行肛门直肠压力测定 ,并与 40例正常人进行对比。结果 便秘组肛管静息压、最大缩榨压、最大缩榨间期及缩榨指数均明显低于对照组 (P <0 0 5 ,P <0 0 5 ,P <0 0l,P<0 0 1) ;模拟排便动作时肛管剩余压明显高于对照组 (P <0 0 0 1) ,肛管松弛率、排便指数均低于对照组 ,统计学处理具有显著性差异 ;初始感阈值容量大于对照组 (P <0 0 0 1) ,排便感阈值大于对照组 (P <0 0 5 ) ,最大耐受量明显低于对照组 (P <0 0 1)。

Objective By measured anorectal pressure in patients with chronic idopathic constipation(CIC),we were able to study role of Anorectal Dynamic disorders in pathogenesis of constipation.Methods Study were performed in 40 patients with CIC and 40 healthy subjects. Anorectal pressure were measured with BioLAB monitor of digestive tract and anorectal catheta of solid state manometric transducers (Sandhill Company of American united states ma-made) to observe the characteristic of dynamics in patients with CIC.Results In patients with CIC,anal resting pressure ,maximal squeeze pressure, period of squeeze pressure and squeeze index were significantly lower(P<0.05, P<0.05, P<0.01, P<0.01, respectively).simulated defecation anal residual pressure signifacantly high(P<0.001);the percent anal relaxation and defecation index(DI) were significantly lower (P<0.01) ;thresholds for first sensation, desire to defecate were increased significantly(P<0.001, P<0.05) respectively;maximal tolerable volume decreased significantly(P<0. 01).Conclusion There were abnormal anorectal dynamics and rectal sensitivity decreased in patients with CIC.