Academic Surgical Unit (GI Physiology Unit), Centre of Digestive Diseases, Blizard Institute, Queen Mary University London, Barts and The London School of Medicine and Dentistry, Whitechapel, London, UK.
Colorectal Dis. 2014 Jul;16(7):538-46. doi: 10.1111/codi.12595.
Interpretation of evacuation proctography (EP) images is reliant on robust normative data. Previous studies of EP in asymptomatic subjects have been methodologically limited. The aim of this study was to provide parameters of normality for both genders using EP.
Evacuation proctography was prospectively performed on 46 healthy volunteers (28 women). Proctograms were independently analysed by two reviewers. All established and some new variables of defaecatory structure and function were assessed objectively: anorectal dimensions; anorectal angle changes; evacuation time; percentage contrast evacuated; and incidence of rectal wall morphological 'abnormalities'.
Normal ranges were calculated for all main variables. Mean end-evacuation time was 88 s (95% CI: 63-113) in male subjects and 128 s (95% CI: 98-158) in female subjects; percentage contrast evacuated was 71% (95% CI: 63-80) in male subjects and 65% (95% CI: 58-72) in female subjects. Twenty-six (93%) of 28 female subjects had a rectocoele with a mean depth of 2.5 cm (upper limit = 3.9 cm). Recto-rectal intussusception was found in nine subjects (approximately 20% of both genders); however, recto-anal intussusception was not observed. Only rectal diameter differed significantly between genders. Qualitatively, three patterns of evacuation were present.
This study defines normal ranges for anorectal dimensions and parameters of emptying, as well as the incidence and characteristics of rectal-wall 'abnormalities' observed or derived from EP. These ranges can be applied clinically for subsequent disease comparison.
排空造影直肠测压（EP）图像的解读依赖于可靠的规范数据。既往无症状受试者 EP 的研究在方法学上存在局限性。本研究旨在通过 EP 为男女两性提供正常参数。
前瞻性对 46 例健康志愿者（28 名女性）进行 EP。由两位独立的阅片者对直肠测压影像进行分析。评估了所有已建立的和一些新的排便结构和功能变量：肛门直肠尺寸；肛直角变化；排空时间；排空的对比百分比；以及直肠壁形态“异常”的发生率。
计算出了所有主要变量的正常范围。男性受试者的平均终末排空时间为 88 秒（95%可信区间：63-113），女性为 128 秒（95%可信区间：98-158）；男性排空的对比百分比为 71%（95%可信区间：63-80），女性为 65%（95%可信区间：58-72）。28 名女性中有 26 名（93%）存在直肠前突，平均深度为 2.5 厘米（上限=3.9 厘米）。9 名受试者（约占男女两性的 20%）发现直肠-直肠内套叠，而直肠-肛管内套叠未观察到。仅直肠直径在性别间存在显著差异。从质量上看，存在三种排空模式。
本研究定义了肛门直肠尺寸和排空参数的正常范围，以及从 EP 观察到或推导出的直肠壁“异常”的发生率和特征。这些范围可用于临床后续疾病比较。
