Bielefeldt K, Enck P, Erckenbrecht J F
Department of Internal Medicine, Heinrich-Heine-University, Dusseldorf, Federal Republic of Germany.
Dis Colon Rectum. 1990 Aug;33(8):674-8. doi: 10.1007/BF02150743.
Anorectal function was prospectively evaluated in 43 consecutive patients with fecal incontinence and in 19 healthy volunteers using manometry and electrical stimulation of the anoderm. Both anorectal motor and sensory function was impaired in incontinent patients as compared with healthy controls. Further statistical analysis identified four subgroups of patients showing different pathomechanisms of fecal incontinence: severe combined anorectal motor and sensory dysfunction, isolated anal sphincter dysfunction, isolated anorectal sensory dysfunction, and combined dysfunction of the internal anal sphincter and impaired anorectal sensitivity. These data support the hypothesis that sensory function of both the rectum and the anal canal is an important and independent factor in the preservation of continence.
对43例连续性大便失禁患者和19名健康志愿者进行前瞻性肛管直肠功能评估，采用测压法和肛管皮肤电刺激法。与健康对照组相比，大便失禁患者的肛管直肠运动和感觉功能均受损。进一步的统计分析确定了4个患者亚组，显示出大便失禁的不同发病机制：严重的肛管直肠运动和感觉联合功能障碍、孤立性肛门括约肌功能障碍、孤立性肛管直肠感觉功能障碍以及肛门内括约肌联合功能障碍和肛管直肠敏感性受损。这些数据支持这样的假说，即直肠和肛管的感觉功能是维持大便节制的一个重要且独立的因素。
