Farouk R, Duthie G S, Bartolo D C, MacGregor A B
Department of Surgery, Royal Infirmary, Edinburgh, UK.
Br J Surg. 1992 May;79(5):439-40. doi: 10.1002/bjs.1800790523.
Twenty-two patients with full-thickness rectal prolapse underwent ambulatory fine wire electromyography of the internal and sphincter (IAS), external and sphincter and puborectalis, together with anorectal manometry, using a computerized system. Examinations were performed both before and 3 to 4 months after rectopexy. The median (interquartile range (i.q.r.)) preoperative IAS electromyogram (EMG) frequency was 0.18 (0.05-0.31) Hz and the median (i.q.r.) preoperative resting anal pressure was 28 (15-64) cmH2O. An improvement in the IAS EMG frequency, median (i.q.r.) 0.29 (0.19-0.38) Hz (P less than 0.03), and resting anal pressure, median (i.q.r.) 41 (20-72) cmH2O (P less than 0.05), was recorded after operation, but these variables remained significantly lower than those found in normal controls: median (i.q.r.) IAS EMG frequency 0.44 (0.36-0.48) Hz and median (i.q.r.) resting anal pressure 92 (74-98) cmH2O. We suggest that repair of the prolapse allows the IAS to recover by removing the cause of persistent rectoanal inhibition.
22例全层直肠脱垂患者使用计算机系统，接受了肛门内括约肌（IAS）、外括约肌和耻骨直肠肌的动态细针肌电图检查以及肛门直肠测压。在直肠固定术前后均进行了检查。术前IAS肌电图（EMG）频率的中位数（四分位间距（i.q.r.））为0.18（0.05 - 0.31）Hz，术前静息肛门压力的中位数（i.q.r.）为28（15 - 64）cmH₂O。术后记录到IAS EMG频率有所改善，中位数（i.q.r.）为0.29（0.19 - 0.38）Hz（P < 0.03），静息肛门压力的中位数（i.q.r.）为41（20 - 72）cmH₂O（P < 0.05），但这些变量仍显著低于正常对照组：IAS EMG频率中位数（i.q.r.）为0.44（0.36 - 0.48）Hz，静息肛门压力中位数（i.q.r.）为92（74 - 98）cmH₂O。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。
