Bilali S, Pfeifer J
Department of General Surgery, University Surgical Clinic, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria.
Tech Coloproctol. 2005 Dec;9(3):225-8. doi: 10.1007/s10151-005-0232-3. Epub 2005 Nov 21.
Loss of voluntary contraction of the external anal sphincter is thought to be a factor in fecal incontinence. During anal manometry, computerized systems produce several parameters including fatigue rate (FR), which is the basis for calculating the fatigue rate index (FRI). Our aim was to evaluate FR and FRI and their clinical importance in patients suffering from fecal incontinence or severe constipation.
All patients scheduled for an anal physiology work-up were included in the study. FR was determined by a computer program and FRI was calculated manually with the following equation: FRI (minutes) = [squeeze pressure (mm Hg) - resting pressure (mmHg)] / - FR (mmHg/min). FR and FRI were compared in patients suffering from fecal incontinence (group I) and severe constipation (group II). Furthermore, subgroups (<50 and > or = 50 years of age) were compared. Lastly, a possible relation between length of the high-pressure zone (HPZ) and FR and FRI was assessed.
Between January 2000 and December 2004, 131 patients (96 with fecal incontinence, 35 with constipation) were studied. Both FR and FRI were similar between groups I and II; no significant differences were found when younger and older patients were compared within the same group. We also did not find any relation between HPZ length and either FR or FRI.
FR and FRI do not seem to be helpful in routine colorectal practice for evaluating the strength of the external anal sphincter.
肛门外括约肌自主收缩功能丧失被认为是大便失禁的一个因素。在肛门测压过程中，计算机系统会生成几个参数，包括疲劳率（FR），它是计算疲劳率指数（FRI）的基础。我们的目的是评估FR和FRI及其在大便失禁或严重便秘患者中的临床重要性。
所有计划进行肛门生理学检查的患者均纳入本研究。FR由计算机程序确定，FRI通过以下公式手动计算：FRI（分钟）=[挤压压力（毫米汞柱）-静息压力（毫米汞柱）]/ - FR（毫米汞柱/分钟）。对大便失禁患者（I组）和严重便秘患者（II组）的FR和FRI进行比较。此外，还对亚组（年龄<50岁和≥50岁）进行了比较。最后，评估高压区（HPZ）长度与FR和FRI之间的可能关系。
2000年1月至2004年12月，共研究了131例患者（96例大便失禁患者，35例便秘患者）。I组和II组的FR和FRI相似；在同一组内比较年轻和老年患者时未发现显著差异。我们也未发现HPZ长度与FR或FRI之间存在任何关系。
在常规结直肠检查中，FR和FRI似乎无助于评估肛门外括约肌的力量。
