Prott G, Hansen R, Badcock C, Kellow J, Malcolm A
Gastrointestinal Investigation Unit, Royal North Shore Hospital and University of Sydney, Sydney, Australia.
Neurogastroenterol Motil. 2005 Aug;17(4):595-9. doi: 10.1111/j.1365-2982.2005.00651.x.
There are conflicting recommendations from consensus groups with regard to the assessment of resting anal sphincter pressure. Our aims were to evaluate and compare the performance of three recognized techniques for the clinical measurement of resting anal sphincter pressure.
In each of 54 patients presenting for anorectal manometry, and suffering from constipation or fecal incontinence, three different techniques for assessment of resting anal pressure were undertaken, namely stationary, stationary pull-through and slow pull-through techniques. Resting anal sphincter pressures were compared between groups and between techniques.
Mean resting anal sphincter pressure was lower with stationary, compared with stationary pull-through and slow pull-through, techniques (P < or = 0.002). Resting pressure was higher for constipation than incontinence regardless of technique used (P < 0.00001). The techniques were highly correlated with each other (P < 0.0001). The stationary pull-through technique conferred a minor advantage in the discrimination between constipation and incontinence. The stationary technique required significantly less time for completion (P < 0.0001).
Resting anal sphincter pressure varies according to the specific technique employed, yet each technique is valid. The stationary pull-through technique confers a minor advantage in clinical discrimination of patients, but the stationary technique is more time-efficient. Standardized anal sphincter testing should be established to enable inter-laboratory comparisons.
关于静息肛门括约肌压力的评估，共识小组给出了相互矛盾的建议。我们的目的是评估和比较三种公认的静息肛门括约肌压力临床测量技术的性能。
对54名因便秘或大便失禁前来进行肛肠测压的患者，分别采用三种不同的静息肛门压力评估技术，即静态法、静态牵拉法和缓慢牵拉法。比较各技术组间及不同技术之间的静息肛门括约肌压力。
与静态牵拉法和缓慢牵拉法相比，静态法测得的平均静息肛门括约肌压力较低（P≤0.002）。无论采用何种技术，便秘患者的静息压力均高于大便失禁患者（P<0.00001）。三种技术之间高度相关（P<0.0001）。静态牵拉法在区分便秘和大便失禁方面有轻微优势。静态法完成所需时间明显更少（P<0.0001）。
静息肛门括约肌压力因所采用的具体技术而异，但每种技术都是有效的。静态牵拉法在临床鉴别患者方面有轻微优势，但静态法效率更高。应建立标准化的肛门括约肌检测方法，以便进行实验室间比较。
