Binnie N R, Smith A N, Creasey G H, Edmond P
University Department of Surgery, Western General Hospital, Edinburgh, UK.
Paraplegia. 1991 Sep;29(7):463-9. doi: 10.1038/sc.1991.63.
Ten subjects with severe constipation due to complete spinal cord injury (SCI) had prolonged oro-anal transit time (p less than 0.01), diminished faecal water content (p less than 0.05) and a reduced frequency of defaecation (p less than 0.01) compared to 10 non-SCI subjects. Paraplegics with an implanted Brindley S234 anterior sacral nerve root stimulator had a significant increase in frequency of defaecation (p less than 0.01), compared to the SCI group while the faecal water content was less although not significantly so. The Brindley stimulator group also showed a more rapid colonic transit than the SCI group but this did not reach statistical significance. SCI is associated with constipation which therefore appears to be favourably influenced by the Brindley S234 anterior nerve root stimulator. The effects produced are compatible with stimulation of left colonic motility, which facilitates the emptying of the distal colon, but also suggest that part of the response restricts transit in some areas of the colon or rectum. Since the motility changes induced by the Brindley stimulator do not affect the right colon a relatively greater residence time of the faecal bolus in this part of the large bowel would enhance water absorption.
与10名非脊髓损伤（SCI）受试者相比，10名因完全性脊髓损伤导致严重便秘的受试者口-肛门传输时间延长（p<0.01）、粪便含水量降低（p<0.05）且排便频率降低（p<0.01）。与SCI组相比，植入布林德利S234骶前神经根刺激器的截瘫患者排便频率显著增加（p<0.01），而粪便含水量虽较低但无显著差异。布林德利刺激器组的结肠传输也比SCI组更快，但未达到统计学意义。SCI与便秘有关，因此布林德利S234前神经根刺激器似乎对便秘有有利影响。产生的效果与刺激左半结肠蠕动一致，这有利于远端结肠排空，但也表明部分反应会限制结肠或直肠某些区域的传输。由于布林德利刺激器引起的动力变化不影响右半结肠，粪便团块在大肠这一部分停留时间相对较长会增强水分吸收。
