Mehl J B, Vicente Y A M V A, Dantas R O, Elias J, Cambrea C R, Rocha M C
Department of Surgery, Jundiaí Medical School, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.
Pediatr Surg Int. 2008 Jan;24(1):81-5. doi: 10.1007/s00383-007-2030-7.
There seems to be controversy on the anorectal sphincter presentation and anatomical division, as well as on its functional representation. Evaluation of the anorectal sphincter musculature has been achieved through several methods, including anorectal manometry and computerized tomography, but to date there is no experimental model allowing a detailed manometric study of this muscle complex. In this work, we have developed such a model, which should enable the manometric and radiographic study of the anatomical features and functional mechanisms of sphincteric injuries, as well as the assessment of drug effects on the anorectal musculature upon incontinence and constipation. Twenty-two piglets (aged 25-30 days, weighing 5-7 kg) were studied by anorectal manometry (rectoanal inhibitory reflex and vector volume) and computerized tomography (anorectal angle and anal canal length). The data obtained for the rectoanal inhibitory reflex, represented here as the average and standard deviation, were the following: relaxation duration = 14.75 +/- 3.62 s, sphincter basal pressure = 41.58 +/- 8.20 mmHg, relaxation index = 87.26 +/- 11.52%, speed of relaxation = 5.90 +/- 2.10 mm/s, and speed of relaxation recovery = 4.03 +/- 1.78 mm/s. As for the vector volume, results were as follows: vector volume = 2692.32 +/- 1298.12 mm Hg2 cm, sphincter length = 11.82 +/- 2.74 mm, high pressure zone length = 5.09 +/- 1.34 mm, maximum pressure = 61.50 +/- 20.58 mmHg, and asymmetry index = 43.50 +/- 10.03%. Radiographic evaluation led to the following results: anal canal length = 9.61 +/- 2.14 mm and anorectal angle = 137.91 +/- 7.75 degrees . The experimental model designed here allows both anorectal manometry and computerized tomography to be carried out in the same way it is performed in human beings, as long as animal sedation is strictly controlled.
关于肛门直肠括约肌的表现、解剖划分以及其功能表征似乎存在争议。对肛门直肠括约肌肌肉组织的评估已通过多种方法实现，包括肛门直肠测压法和计算机断层扫描，但迄今为止，尚无实验模型能够对该肌肉复合体进行详细的测压研究。在这项研究中，我们开发了这样一个模型，它应能对括约肌损伤的解剖特征和功能机制进行测压和放射学研究，以及评估药物对肛门直肠肌肉组织在大小便失禁和便秘方面的影响。通过肛门直肠测压法（直肠肛门抑制反射和向量容积）和计算机断层扫描（肛门直肠角和肛管长度）对22只仔猪（年龄25 - 30天，体重5 - 7千克）进行了研究。直肠肛门抑制反射获得的数据（此处以平均值和标准差表示）如下：松弛持续时间 = 14.75 +/- 3.62秒，括约肌基础压力 = 41.58 +/- 8.20毫米汞柱，松弛指数 = 87.26 +/- 11.52%，松弛速度 = 5.90 +/- 2.10毫米/秒，以及松弛恢复速度 = 4.03 +/- 1.78毫米/秒。至于向量容积，结果如下：向量容积 = 2692.32 +/- 1298.12毫米汞柱²厘米，括约肌长度 = 11.82 +/- 个2.74毫米，高压区长度 = 5.09 +/- 1.34毫米，最大压力 = 61.50 +/- 20.58毫米汞柱，以及不对称指数 = 43.50 +/- 10.03%。放射学评估得出以下结果：肛管长度 = 9.61 +/- 2.14毫米，肛门直肠角 = 137.91 +/- 7.75度。只要严格控制动物镇静，此处设计的实验模型就能使肛门直肠测压法和计算机断层扫描以与人类相同的方式进行。
