肛门内括约肌解剖生理学研究进展（Advances in anatomy and physiology of the anal sphincter）.docVIP

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肛门内括约肌解剖生理学研究进展（Advances in anatomy and physiology of the anal sphincter）.doc

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肛门内括约肌解剖生理学研究进展（Advances in anatomy and physiology of the anal sphincter）

肛门内括约肌解剖生理学研究进展（Advances in anatomy and physiology of the anal sphincter） Sphincter thickness ratio is generally 1:1. 5, but sometimes very different, up to 1:3 or 1:5, IAS very thin and thick EAS accounted for 17. 3%, some lower EAS skin several full-length 1/2 for anal; on the contrary, EAS also very weak and the thickness of IAS over EAS. In the lower part of the IAS, there is a fibrous insertion from the joint longitudinal muscle to form the suspensory ligament of the mucosa. The anal duct also traverses the IAS, where some of the anal duct terminates in the intermuscular compartment of the internal and external sphincter. Physiology of 2 IAS 2. 1 IAS EMG activity IAS continues to maintain tension and exhibits slow and ultra slow waves at intervals. In the static pressure recorder, the slow wave is low amplitude wave with a frequency of 10 ~ 20/min [1]. Dynamic manometry confirmed that slow wave is the main movement of the anal canal [2]. The frequency of these waves is highest at the distal end of the anal canal, which may help maintain the distal anal space and keep the anal epithelium sensitive and insensitive. Anal slow wave activity plays an important role in anal control [3]. About 10% of healthy people exhibit ultra slow waves, with frequencies of 2/min. Ultra slow waves are more common in hemorrhoid patients and disappear after hemorrhoidectomy, indicating that they may be caused by anal pads. These waves can be detected on separate IAS, indicating that they originated from IAS [4~6]. Penninckx et al suggest that the ultra slow wave may be produced by rectal activity and manifested as IAS relaxation [6]. Patients with idiopathic fecal incontinence often exhibit ultra slow wave loss, and even if they do, the amplitude is generally reduced [7]. 2. 2 IAS mechanical activity Under quiet conditions, IAS is in a tense state of contraction, which is one of the reasons for the formation of pressure in the anal canal. But the mechanism of its tonic contraction is