Fathy Abeer, Megahed Ahmed, Barakat Tarik, Abdalla Ahmed F
Paediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura City, Egypt.
Arab J Gastroenterol. 2013 Mar;14(1):6-9. doi: 10.1016/j.ajg.2013.02.001. Epub 2013 Mar 13.
Chronic functional constipation represents 95% of the cases of paediatric constipation. Epidemiologic data, pathophysiology and anorectal functional abnormalities vary greatly among different reports across different populations. The aim of this study was to evaluate these data in Egyptian children with chronic functional constipation.
This study included 150 children with chronic functional constipation (101 males, 49 females; mean age 6 ± 3.1 years); a control group of 50 age- and sex-matched healthy children were enrolled for standardisation of the manometry technique. A structured symptom questionnaire and clinical examination including digital rectal examination in addition to anorectal manometry were done for all included children. Defaecation dynamics were assessed in all children 5 years or older using anorectal manometry with integrated electromyogram of the external anal sphincter and the puborectalis muscle.
The maximal tolerable volume was significantly higher in the constipated children than in the control group (p=0.03). No significant differences existed between constipated and control children regarding other anorectal manometric parameters. Abnormal defaecation dynamics were detected in 35 out of 95 tested patients (36.8%).
Increased maximal tolerable volume is the most striking manometric feature in Egyptian children with chronic functional constipation. Abnormal defaecation dynamics were detected in about one-third of the tested patients. Standardisation of the measurement techniques and obtaining normal ranges for anorectal manometric parameters for each laboratory are recommended.
慢性功能性便秘占小儿便秘病例的95%。不同人群的不同报告中，流行病学数据、病理生理学及肛门直肠功能异常差异很大。本研究旨在评估埃及慢性功能性便秘患儿的这些数据。
本研究纳入150例慢性功能性便秘患儿（男101例，女49例；平均年龄6±3.1岁）；选取50例年龄和性别匹配的健康儿童作为对照组，用于测压技术的标准化。对所有纳入患儿进行结构化症状问卷、临床检查（包括直肠指检）以及肛门直肠测压。对所有5岁及以上儿童使用肛门直肠测压结合肛门外括约肌和耻骨直肠肌的肌电图评估排便动力学。
便秘患儿的最大耐受量显著高于对照组（p=0.03）。便秘患儿与对照儿童在其他肛门直肠测压参数方面无显著差异。95例受试患者中有35例（36.8%）检测到排便动力学异常。
最大耐受量增加是埃及慢性功能性便秘患儿最显著的测压特征。约三分之一的受试患者检测到排便动力学异常。建议对测量技术进行标准化，并为每个实验室获取肛门直肠测压参数的正常范围。
