中国普外基础与临床杂志

中国普外基础与临床杂志

便秘型肠易激综合征患者肛门直肠感觉及动力学变化的临床研究

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目的 探讨便秘型肠易激综合征(IBS-C)患者的肛门动力学变化及肛门直肠感觉功能并检测其盆底肌电压情况。 方法 选择 2014 年 12 月 1 日至 2017 年 12 月 1 日期间中国人民解放军第五医院消化内科收治的 IBS-C 患者 36 例(IBS-C 组)及正常健康志愿者 28 例(对照组),分别采用 ZJ-D3 型肛肠压力检测仪、生物刺激反馈仪检测 2 组受试者的直肠肛管压力(肛管静息压、直肠静息压、肛管直肠压差、肛管高压区域长度、直肠感觉阈值及直肠顺应性)和盆底肌电压状态变化并进行比较。 结果 IBS-C 组的直肠静息压、肛管静息压分别与对照组比较差异均无统计学意义(P>0.05),但 IBS-C 组的肛管直肠压差明显高于对照组(t=4.37,P=0.017),IBS-C 组的肛管高压区域长度明显长于对照组(t=6.18,P=0.042)。IBS-C 组盆底肌的最大肌电压、最小肌电压及电压频率均明显高于对照组(t=3.39,P=0.031;t=5.76,P=0.042;t=8.41,P<0.001)。 结论 肛门直肠动力学、直肠感觉功能异常可能是 IBS-C 的重要病因之一,IBS-C 可能存在异常的盆底肌肌电压变化。

Objective To investigate changes in anal dynamics and anorectal sensory function in patients with irritable bowel syndrome with constipation (IBS-C) and detect its muscle pressure of basin. Methods Thirty-six patients with IBS-C (IBS-C group) and 28 healthy volunteers (control group) were collected. The rectal-anal canal pressure and the changes of the basin’s myoelectric status were detected by the ZJ-D3 gastrointestinal motility tester and bio-stimulus feedback instrument. The anal canal resting pressure, rectal resting pressure, anorectal pressure difference, length of anal canal high pressure area, rectal sensation threshold, rectal compliance, and basin muscle voltage were measured and compared between these two groups. Results There were no significant differences in the rectal resting pressure and anal canal resting pressure between the IBS-C group and the control group (t=–2.31, P=0.85; t=–5.46, P=0.28), but the difference value of anorectal pressure of the IBS-C group was significantly higher than that of the control group (t=4.37, P=0.017), and the length of the anal canal hypertension area in the IBS-C group was significantly longer than that of the control group (t=6.18, P=0.042). The maximal muscle voltage, minimum muscle voltage, and voltage frequency of the pelvic floor in the IBS-C group were significantly higher than those in the control group (t=3.39, P=0.031; t=5.76, P=0.042; t=8.41, P<0.001). Conclusion Anorectal dynamics and rectal sensory dysfunction are one of important causes of IBS-C, it might be existed abnormal changes in muscle voltage of pelvic floor muscle.

关键词: 便秘型肠易激综合征; 肛门直肠动力学; 肛门直肠感觉

Key words: irritable bowel syndrome with constipation; anorectal dynamic; anorectal sensation

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