Kim Gi-Wook, Won Yu-Hui, Ko Myoung-Hwan, Park Sung-Hee, Seo Jeong-Hwan
a Department of Physical Medicine and Rehabilitation , Research Institute of Clinical Medicine, Institute for Medical Science, Chonbuk National University Medical School and Hospital , Jeonju City , Republic of Korea.
J Spinal Cord Med. 2016 May;39(3):301-6. doi: 10.1179/2045772314Y.0000000282. Epub 2016 Feb 11.
The aim of this study was to determine the efficacy of measuring the diameter and area of the rectum using ultrasonography as an additional parameter for the evaluation of neurogenic bowel in patients with spinal cord injury (SCI).
In total, 32 patients with SCI (16 patients with upper motor neuron neurogenic bowel (UMNB) and 16 patients with lower motor neuron neurogenic bowel (LMNB)) participated in this study. We divided the patients by the type of neurogenic bowel: UMNB, patients with supraconal lesions and recovery state of spinal shock or LMNB, patients with infraconal/caudal lesions or spinal shock state).
Ultrasound was applied on the abdomen and measured the diameter and area of the rectum were measured twice each before and after defecation, respectively.
We compared rectal diameter and area before/after defecation between the two groups, and significant differences were found in both rectal diameter and area before/after defecation in each group.
After defecation, those in the UMNB group had smaller rectal diameters and areas than those in the LMNB group. Significant reduction of rectal diameter and area was observed after defecation as well. The LMNB group showed slightly increased rectal area after defecation, but the increase was not statistically significant.
Using ultrasound to measure rectal diameter and area seems helpful for classifying neurogenic bowel types and for understanding the neurogenic bowel among SCI patients with symptoms of neurogenic bowel.
本研究的目的是确定使用超声测量直肠直径和面积作为评估脊髓损伤(SCI)患者神经源性肠道的附加参数的有效性。
共有32例SCI患者(16例上运动神经元神经源性肠道(UMNB)患者和16例下运动神经元神经源性肠道(LMNB)患者)参与了本研究。我们根据神经源性肠道类型对患者进行了分组:UMNB,圆锥上病变及脊髓休克恢复状态的患者;或LMNB,圆锥下/尾侧病变或脊髓休克状态的患者。
在腹部进行超声检查,分别在排便前后各测量两次直肠直径和面积。
我们比较了两组排便前后的直肠直径和面积,发现每组排便前后的直肠直径和面积均存在显著差异。
排便后,UMNB组的直肠直径和面积小于LMNB组。排便后直肠直径和面积也显著减小。LMNB组排便后直肠面积略有增加,但增加无统计学意义。
使用超声测量直肠直径和面积似乎有助于对神经源性肠道类型进行分类,并有助于了解有神经源性肠道症状的SCI患者的神经源性肠道情况。