Nagashima M, Iwai N, Yanagihara J, Shimotake T
Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Japan.
J Pediatr Surg. 1992 Oct;27(10):1273-7. doi: 10.1016/0022-3468(92)90272-9.
Motility of the rectosigmoid and rectum and reservoir function of the rectum after surgery for anorectal malformations were investigated in 32 patients (17 with high type, 6 with intermediate type, and 9 with low type anomaly) aged 5 to 16 years. All 32 patients were examined manometrically as well as with a newly devised myoelectrical method. Manometry showed that the values of maximum anal pressure and anorectal pressure difference in the high type were significantly lower than those in the low type. However, the incidence of contractile activity of the rectosigmoid was not significantly different between these two groups. The threshold sensation pressure and the maximum tolerable pressure in the high type were significantly higher than those in the low type, and the rectal compliance in the high type was significantly lower than that in the low type. Electromyography was recorded at 8 cm and 5 cm from the anal verge. Two types of slow waves were observed, a faster rhythm and a slower rhythm. Their frequency was similar in the three groups. However, the numbers of spike bursts in the high type and intermediate type were significantly higher than those in the low type. These results indicate that in addition to an inadequate anal resting pressure a loss of optimal rectal sensation or rectal reservoir function might be associated with fecal incontinence in the high type and that increased spike bursts might play some role in rectal motility.
对32例年龄在5至16岁的肛门直肠畸形手术后患者（17例高位型、6例中间型、9例低位型异常）的直肠乙状结肠和直肠运动以及直肠储袋功能进行了研究。所有32例患者均接受了测压检查以及一种新设计的肌电方法检查。测压显示，高位型的最大肛管压力和肛管直肠压力差的值显著低于低位型。然而，这两组之间直肠乙状结肠收缩活动的发生率没有显著差异。高位型的阈值感觉压力和最大耐受压力显著高于低位型，高位型的直肠顺应性显著低于低位型。在距肛缘8 cm和5 cm处记录肌电图。观察到两种慢波，一种较快的节律和一种较慢的节律。它们的频率在三组中相似。然而，高位型和中间型的棘波爆发数量显著高于低位型。这些结果表明，除了肛管静息压力不足外，最佳直肠感觉或直肠储袋功能的丧失可能与高位型大便失禁有关，并且增加的棘波爆发可能在直肠运动中起一定作用。
