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[直肠脱垂直肠固定术后肛门内括约肌的功能恢复与控便能力的恢复]

[The functional recovery of the internal anal sphincter and the restoration of continence after rectopexy for rectal prolapse].

作者信息

Gammarota F V, Farouk R, Duthie G S, Bartolo D C

机构信息

Dept. of Surgery, Royal Infirmary of Edinburgh.

出版信息

G Chir. 1992 Nov-Dec;13(11-12):527-31.

PMID:1292560
Abstract

Eleven patients with full thickness rectal prolapse underwent ambulatory fine wire electromyography (EMG) of the internal anal sphincter (IAS), external anal sphincter and puborectalis muscle, and anorectal manometry using a computerised system. Examinations were performed preoperatively and at 3 months following rectopexy. The median preoperative IAS EMG frequency was 0.21 Hz (range = 0.05-0.30) and the median preoperative resting anal pressure (RAP) was 13 cmH2O (range = 2-84 cmH2O). A significant improvement in the IAS EMG frequency (median = 0.31 Hz; 0.23-0.47 Hz; p < 0.02) and RAP (median = 30 cmH2O; 20-84 cmH2O; p < 0.01) was noted post-rectopexy but these parameters remained significantly different from a group of normal controls (median IAS EMG frequency = 0.48 Hz; 0.25-0.61 Hz; median RAP = 76 cmH2O; 22-120 cmH2O). We suggest that repair of the prolapse allows the IAS to recover by removing the cause of persistent recto-anal inhibition.

摘要

11例全层直肠脱垂患者接受了肛门内括约肌(IAS)、肛门外括约肌和耻骨直肠肌的动态细针肌电图(EMG)检查,并使用计算机系统进行了肛肠测压。术前及直肠固定术后3个月进行检查。术前IAS肌电图频率中位数为0.21Hz(范围=0.05 - 0.30),术前静息肛管压力(RAP)中位数为13cmH₂O(范围=2 - 84cmH₂O)。直肠固定术后IAS肌电图频率(中位数=0.31Hz;0.23 - 0.47Hz;p<0.02)和RAP(中位数=30cmH₂O;20 - 84cmH₂O;p<0.01)有显著改善,但这些参数与一组正常对照仍有显著差异(IAS肌电图频率中位数=0.48Hz;0.25 - 0.61Hz;RAP中位数=76cmH₂O;22 - 120cmH₂O)。我们认为,脱垂修复通过消除持续性直肠 - 肛门抑制的原因,使IAS得以恢复。

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