肛门直肠测压在便秘诊断中的作用及意义-第三军医大学学报.doc

肛门直肠测压在便秘诊断中的作用 王 李1，高 羽1，刘正勇1，邓小炼1，吴劲松1，谭智勇2，刘宝华1 （400042 重庆，第三军医大学大坪医院野战外科研究所普通外科，全军便秘诊治中心1；404500 重庆，重庆市云阳县人民医院普外科2） [摘要] 目的 研究不同类型便秘患者的肛门直肠测压表现及肛门直肠测压在便秘诊断中的作用。方法 收集我科便秘患者163例，将其分类为结肠慢传输型便秘46例，出口梗阻型便秘93例，混合型便秘24例。正常对照组30例。用肛门直肠测压方法检测各组患者的直肠初始感觉容量、初始便意容量、最大耐受容量以及肛管静息压、收缩压、咳嗽时肛管压和排便时肛管压，分析统计其测压数据并进行比较。结果 与对照组相比，便秘组患者直肠初始感觉容量、初始便意容量差异无统计学意义，而最大耐受容量明显增加，差异有统计学意义(P0.05)。便秘组所有患者肛管静息压、肛管收缩压均明显低于对照组，差异有统计学意义(P0.05)。STC组患者肛管静息压、肛管收缩压、咳嗽时肛管压及排便时肛管压均明显低于对照组及OOC组，差异均有统计学意义(P0.05)；而OOC型患者排便时肛管压明显增高，差异有统计学意义(P0.05)。结论 不同类型的便秘患者其肛肠测压表现不同，提示便秘患者存在着肛门直肠动力异常和直肠感觉异常。 [关键词] 便秘；肛门直肠测压 [中图分类号] R574.4 [文献标志码] A [基金项目] 重庆市国际合作项目（2011GZ0045）；国家自然科学基金；重庆市自然科学基金（CSTC2011jjA0559） [通信作者] 刘宝华，电话：（023E-mail: lbh57268@163.com The significance of Anorectal Manometry in Constipation Wang Li1，Gao Yu1，Liu Zhengyong1，Deng Xiaolian1，Wu Jingsong1，Tan zhiyong2，Liu Baohua1 （1Department of GastricColorectal Surgery, Daping Hospital, Third Military Medical University；2 Department of General Surgery Yunyang Hospital; Chongqing，400042, China） [Abstract] Objective: To investigate the appearance and significance of anorectal manometry in different type patients with constipation. Methods: 163 patients in our?department?in patients with constipation were collected,its classification for?colonic slow transit constipation?(46 cases), outlet obstruction constipation(93 cases)?, mixed constipation(24 cases)and normal?control group( 30 cases).Anorectal manometry was carried out in controls and patients with chronic constipation. The rectal first sensation, first defecation sensation and maximum tolerable volume and anal resting pressure, squeeze pressure, coughing pressure and defecation pressure were determined. the pressure measuring?data were statistical analysised and compared. Results: No difference of rectal first sensation, first defecation sensation were found between patients and controls,while maximum tolerable volume significantly higher (P 0. 05). The anal r