三维高清测压法在先天性巨结肠症患儿术后评估中的应用：一项初步研究

3D high-definition manometry in evaluation of children after surgery for Hirschsprung's disease: A pilot study.

作者信息

Banasiuk Marcin, Banaszkiewicz Aleksandra, Piotrowski Dariusz, Albrecht Piotr, Kamiński Andrzej, Radzikowski Andrzej

机构信息

Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.

出版信息

Adv Med Sci. 2016 Mar;61(1):18-22. doi: 10.1016/j.advms.2015.07.008. Epub 2015 Aug 10.

DOI:10.1016/j.advms.2015.07.008

PMID:26344909

Abstract

PURPOSE

Anorectal 3-dimensional high definition manometry (3D HRM) could be the best tool for postoperative assessment of restorative surgical procedures for Hirschsprung's disease. The aim of our study was to evaluate patients after surgery for Hirschsprung's disease using 3D HRM.

MATERIALS AND METHODS

Anorectal function was evaluated using solid state 3D HRM. We measured the length of the anal canal, mean resting squeeze pressures, the presence of rectoanal inhibitory reflex, cough reflex, ano-anal reflex and the bear down manoeuvre.

RESULTS

We studied 14 children operated on for Hirschsprung's disease. The mean values of pressure asymmetry were higher in patients after the Duhamel procedure than after the TEPT procedure (29.58% vs. 22.26% during resting and 26.1% vs. 14.01% during squeeze, respectively). No difference between the groups was observed in the measurement of all the manometric parameters except the presence of rectoanal inhibitory reflex (87.5% after TEPT vs. 33% after Duhamel).

CONCLUSIONS

Anorectal 3D HRM evaluation of patients with Hirschsprung's disease demonstrated that the asymmetry of the anal canal occurred in a similar percentage after both procedures.

摘要

目的

直肠肛管三维高分辨率测压法（3D HRM）可能是先天性巨结肠根治性手术术后评估的最佳工具。我们研究的目的是使用3D HRM评估先天性巨结肠手术后的患者。

材料与方法

使用固态3D HRM评估直肠肛管功能。我们测量了肛管长度、静息平均挤压压力、直肠肛管抑制反射、咳嗽反射、肛门-肛门反射的存在情况以及用力排便动作。

结果

我们研究了14例接受先天性巨结肠手术的儿童。Duhamel手术后患者的压力不对称平均值高于经肛门直肠拖出术（TEPT）后患者（静息时分别为29.58%对22.26%，挤压时分别为26.1%对14.01%）。除直肠肛管抑制反射的存在情况外，两组在所有测压参数的测量上均未观察到差异（TEPT后为87.5%，Duhamel后为33%）。