Rao S S, Hatfield R, Soffer E, Rao S, Beaty J, Conklin J L
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, USA.
Am J Gastroenterol. 1999 Mar;94(3):773-83. doi: 10.1111/j.1572-0241.1999.00950.x.
Although tests of anorectal function are useful in the assessment of defecation disorders, there is inadequate and inconsistent information regarding normative data. Also, there are discrepancies in manometric techniques and data interpretation. Our aim was to perform a comprehensive evaluation of anorectal function in healthy adults.
We used a 6-mm diameter probe containing six radially arrayed microtransducers, and a 4-cm-long latex balloon for performing anorectal manometry in 45 healthy subjects who were controlled for gender and age. Sequentially, subjects were asked to squeeze, bear down, or blow up a party balloon. Subsequently, rectal sensation, rectal compliance, and rectoanal reflexes were assessed simultaneously by performing intermittent phasic balloon distentions. Additionally, balloon defecation, pudendal nerve latency, and saline continence tests were performed.
In men, the anal sphincter was longer (p < 0.05) and squeeze sphincter pressure and squeeze duration were higher (p < 0.01), but resting sphincter pressure was similar to that in women. When bearing down, although not significant, the defecation index was higher in men. Distinct thresholds for rectal sensation were identified but there was no gender difference. Likewise, rectal compliance and balloon expulsion time were similar. However, during saline infusion, the onset of first leak and total volume retained were higher (p < 0.001) and pudendal nerve latency was shorter (p < 0.05) in men. Overall, parity or age did not influence anorectal function.
This study represents the most comprehensive age- and gender-controlled assessment of anorectal function using solid state technology. Gender influences some parameters of anorectal function. Our results could serve as a valuable resource of normative data.
尽管肛门直肠功能测试在排便障碍评估中很有用，但关于正常数据的信息不足且不一致。此外，测压技术和数据解释也存在差异。我们的目的是对健康成年人的肛门直肠功能进行全面评估。
我们使用了一个直径6毫米、包含六个径向排列的微型换能器的探头，以及一个4厘米长的乳胶气球，对45名按性别和年龄进行匹配的健康受试者进行肛门直肠测压。依次要求受试者挤压、用力排便或吹气球。随后，通过间歇性阶段性气球扩张同时评估直肠感觉、直肠顺应性和直肠肛门反射。此外，还进行了气球排便、阴部神经潜伏期和盐水控便测试。
男性的肛门括约肌更长（p < 0.05），挤压括约肌压力和挤压持续时间更高（p < 0.01），但静息括约肌压力与女性相似。用力排便时，男性的排便指数虽无显著差异但更高。确定了不同的直肠感觉阈值，但无性别差异。同样，直肠顺应性和气球排出时间相似。然而，在注入盐水时，男性首次漏液的起始时间和保留的总体积更高（p < 0.001），阴部神经潜伏期更短（p < 0.05）。总体而言，生育情况或年龄不影响肛门直肠功能。
本研究是使用固态技术对肛门直肠功能进行的最全面的年龄和性别匹配评估。性别会影响肛门直肠功能的一些参数。我们的结果可作为有价值的正常数据资源。
