129例顽固性便秘的病因分析.docVIP

129例顽固性便秘的病因分析 【摘要】 目的 通过129例顽固性便秘的排粪造影检查结果分析，探讨便秘与功能性出口梗阻及顽固性便秘之间的关系。方法 对有长期便秘史近期加重的129例顽固性便秘患者应用数字胃肠机进行排粪造影检查并将其结果与40例无便秘史的对照组进行比较。结果 129例中发现直肠黏膜脱垂、套叠38例，直肠前突101例，盆底疝28例，会阴下降52例，耻骨直肠肌肥厚11例。合并上述两项以上者79例。对照组中直肠黏膜脱垂、套叠6例，直肠前突17例，盆底疝3例，会阴下降11例，耻骨直肠肌肥厚0例。两组功能性出口梗阻的检出率有显著差异。结论 长期慢性便秘是功能性出口梗阻的原因之一，功能性出口梗阻又在原有便秘的基础上加重便秘，进而形成顽固性便秘。 论文联盟www.LWLM.com编辑。 【关键词】 排粪造影;便秘;功能性出口梗阻;顽固性便秘 [Abstract] Objective To study the relation between constipation and functional outlet obstruction. Methods A total of 129 patients with intractable constipation, who had been keeping longtermed constipation and whose symptoms deteriorated recently, were checked by defecography. And another team of 40 cases without constipation was examined in the same way. Results In the team of 129 cases, the prolapse of rectal mucosa and rectum intussusception were found in 38 pationts, anterior rectocele in 101 cases, hernia of pelvic floor in 28 cases, decending pelvic floor and perineum in 52cases, puborectlis muscle hypertrophy 11 cases. In the other team of 40 cases without constipation, the above image changes were respectively found in 6, 21, 3, 11, and 0 patients. And 79 cases of 129 patients were found to have at less two image changes of the above simultaneously. There was distinctive significant difference in the positive rate between the two teams’. Conclusion Functional outlet obstruction constipation can certainly result from longtermed chronic constipation, and it can undoubtedly make the constipation from bad to worse on the original basis, and what’s more, it will lead to stubborn constipation. [Key words] Defecography; Constipation; Obstruction of functional outlet; Intractable constipation 便秘作为许多疾病的一个症状[1] , 许多人不以为然，且往往不来 医院 就诊。随着持续时间的延长及年龄的增大，症状进行性加重，最后形成多种原因混合存在的顽固性便秘，其中就包括功能性出口梗阻型便秘。功能性出口梗阻系指只有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，包括：直肠黏膜脱垂、套叠，直肠前突，盆底疝，会阴下降，耻骨直肠肌肥厚等。排粪造影是诊断功能性出口梗阻的重要X线检查方法[3] 。 1 资料和方法 1.1 一般资料 搜集我院2003～2005年应用数字胃肠机作排粪造影检查的129例顽固性便秘患者和40例无便秘症状的志愿者。 本组129例，男21例，女108例，年龄最大