膀胱充盈对肛门直肠功能的影响。

Crosbie J J, Eguare E, McGovern B, Keane F B V

Department of Surgery, The Adelaide & Meath Hospital, Tallaght, Dublin 24, Ireland.

Colorectal Dis. 2003 May;5(3):251-5. doi: 10.1046/j.1463-1318.2003.00431.x.

OBJECTIVE

The aim of this study was to develop a technique to simultaneously evaluate bladder and anorectal function. In particular, this study was designed to determine if anal sphincter resting pressure, anal sphincter squeeze pressure and rectal sensation change with bladder filling.

PATIENT AND METHODS

A pilot study of ten female patients who presented to the pelvic physiology unit for assessment of urinary symptoms was performed. All patients completed a symptom questionnaire and quality of life assessment form. Following informed consent a baseline urodynamic test was performed with the bladder empty and subsequently followed by an anorectal manometric test. Changes in anal sphincter resting pressure, squeeze pressure and rectal pressure were recorded over a ten-minute period. With the patient lying in the left lateral position, the bladder was then filled with isotonic saline at room temperature at a constant rate of 30 ml/min. A continuous assessment of changes in anal sphincter resting pressure during bladder filling was made. Anal sphincter squeeze pressure and rectal sensation were measured at fixed intervals during bladder filling (50, 100, 150 ml etc.) and at fixed intervals relative to bladder capacity (25, 50, 75 and 100% capacity) by stopping bladder filling at the appropriate level.

RESULTS

There was no significant change in anal sphincter resting pressure (Mean difference(s.d.) between bladder full and empty = 2.7(5.6) P = 0.92*), squeeze pressure (Mean(s.d.) difference = 9.5(26.3) P = 0.86*) and rectal sensation (Mean difference(s.d.) first sensation 10(15.2) P = 0.958; Mean difference(s.d.) urgency = 10(17.8) P = 0.07*) on bladder filling.

CONCLUSION

Under normal physiological circumstances, bladder filling does not influence anorectal function. *

STATISTICAL ANALYSIS

Wilcoxon signed rank sum test. P < 0.05 considered significant. Units = mmHg

目的

本研究旨在开发一种同时评估膀胱和肛门直肠功能的技术。具体而言，本研究旨在确定肛门括约肌静息压力、肛门括约肌收缩压力和直肠感觉是否会随着膀胱充盈而变化。

患者与方法

对十名到盆底生理学单元评估泌尿症状的女性患者进行了一项初步研究。所有患者均完成了症状问卷和生活质量评估表。在获得知情同意后，先在膀胱排空状态下进行了一次基线尿动力学测试，随后进行了肛门直肠测压测试。在十分钟内记录肛门括约肌静息压力、收缩压力和直肠压力的变化。患者左侧卧位时，然后以30毫升/分钟的恒定速率用室温等渗盐水充盈膀胱。在膀胱充盈过程中持续评估肛门括约肌静息压力的变化。在膀胱充盈期间（50、100、150毫升等）以及相对于膀胱容量的固定间隔（25%、50%、75%和100%容量），通过在适当水平停止膀胱充盈来测量肛门括约肌收缩压力和直肠感觉。

结果

膀胱充盈时，肛门括约肌静息压力（膀胱充盈与排空时的平均差异（标准差）=2.7（5.6），P=0.92*）、收缩压力（平均（标准差）差异=9.5（26.3），P=0.86*）和直肠感觉（首次感觉的平均差异（标准差）=10（15.2），P=0.958；尿急的平均差异（标准差）=10（17.8），P=0.07*）均无显著变化。