Gammarota F V, Farouk R, Duthie G S, Bartolo D C
Dept. of Surgery, Royal Infirmary of Edinburgh.
G Chir. 1992 Nov-Dec;13(11-12):527-31.
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.
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。
