Lynch A C, Anthony A, Dobbs B R, Frizelle F A
Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
Spinal Cord. 2000 Oct;38(10):573-80. doi: 10.1038/sj.sc.3101076.
Spinal cord injured (SCI) patients have delayed colonic motility and anorectal dysfunction resulting in functional obstruction and constipation. This may be caused by changes in descending modulation from the central or sympathetic nervous systems. Anorectal dyssynergy may demonstrate similarities to that seen in the bladder following SCI.
Anorectal manometry was performed on 37 SCI volunteers. Patterns of rectal and sphincter function were identified. These patterns were then compared with questionnaire answers on bowel function and cystometrograms to identify a relationship between detrusor dyssynergy and anal sphincter tone.
Rectal compliance and basal resting sphincter pressures were lower than normal values. Ramp rectal inflation demonstrated patterns of sphincter activity similar to that recorded in the patients' cystometrograms. There is no definite relationship of bowel function to the findings on manometry in SCI patients.
SCI patients have abnormal anorectal function. Anorectal manometry results were able to be classified into four patterns on the basis of rectal pressure and sphincter tone in response to rectal distention. The patterns of anorectal manometry seen were similar to those in cystometrograms, however there is no definite relationship to bowel dysfunction. Spinal Cord (2000) 38, 573 - 580.
脊髓损伤（SCI）患者存在结肠动力延迟和肛门直肠功能障碍，导致功能性梗阻和便秘。这可能是由中枢神经系统或交感神经系统下行调节的改变引起的。肛门直肠协同失调可能与SCI后膀胱出现的协同失调有相似之处。
对37名SCI志愿者进行了肛门直肠测压。确定了直肠和括约肌功能的模式。然后将这些模式与关于肠道功能的问卷答案以及膀胱测压图进行比较，以确定逼尿肌协同失调与肛门括约肌张力之间的关系。
直肠顺应性和基础静息括约肌压力低于正常值。直肠斜坡充气显示出的括约肌活动模式与患者膀胱测压图中记录的模式相似。在SCI患者中，肠道功能与测压结果之间没有明确的关系。
SCI患者存在异常的肛门直肠功能。根据直肠压力和对直肠扩张的括约肌张力，肛门直肠测压结果可分为四种模式。所观察到的肛门直肠测压模式与膀胱测压图中的模式相似，然而与肠道功能障碍没有明确的关系。《脊髓》（2000年）第38卷，第573 - 580页 。
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