Koo Bon Il, Bang Tae Sik, Kim Soo-Yeon, Ko Sung Hwa, Kim Wan, Ko Hyun-Yoon
Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea.; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Ann Rehabil Med. 2016 Jun;40(3):528-33. doi: 10.5535/arm.2016.40.3.528. Epub 2016 Jun 29.
To assess the correlation between the anorectal function and bladder detrusor function in patients with complete spinal cord injury (SCI) according to the type of lesion.
Medical records of twenty-eight patients with SCI were included in this study. We compared the anorectal manometric and urodynamic (UD) parameters in total subjects. We analyzed the anorectal manometric and UD parameters between the two groups: upper motor neuron (UMN) lesion and lower motor neuron (LMN) lesion. In addition, we reclassified the total subjects into two groups according to the bladder detrusor function: overactive and non-overactive.
In the group with LMN lesion, the mean value of maximal anal squeeze pressure (MSP) was slightly higher than that in the group with UMN lesion, and the ratio of MSP to maximal anal resting pressure (MRP) was statistically significant different between the two groups. In addition, although the mean value of MSP was slightly higher in the group with non-overactive detrusor function, there was no statistical correlation of anorectal manometric parameters between the groups with overactive and non-overactive detrusor function.
The MSP and the ratio of MSP to MRP were higher in the group with LMN lesion. In this study, we could not identify the correlation between bladder and bowel function in total subjects. We conclude that the results of UD study alone cannot predict the outcome of anorectal manometry in patients with SCI. Therefore, it is recommended to perform assessment of anorectal function with anorectal manometry in patients with SCI.
根据脊髓损伤类型评估完全性脊髓损伤(SCI)患者的肛门直肠功能与膀胱逼尿肌功能之间的相关性。
本研究纳入了28例SCI患者的病历。我们比较了所有受试者的肛门直肠测压和尿动力学(UD)参数。我们分析了上运动神经元(UMN)损伤组和下运动神经元(LMN)损伤组之间的肛门直肠测压和UD参数。此外,我们根据膀胱逼尿肌功能将所有受试者重新分为两组:逼尿肌过度活动组和非逼尿肌过度活动组。
在LMN损伤组中,最大肛门收缩压(MSP)的平均值略高于UMN损伤组,且两组之间MSP与最大肛门静息压(MRP)的比值有统计学显著差异。此外,尽管逼尿肌功能非过度活动组的MSP平均值略高,但逼尿肌功能过度活动组和非过度活动组之间的肛门直肠测压参数无统计学相关性。
LMN损伤组的MSP以及MSP与MRP的比值更高。在本研究中,我们未能确定所有受试者膀胱和肠道功能之间的相关性。我们得出结论,仅UD研究结果不能预测SCI患者肛门直肠测压的结果。因此,建议对SCI患者进行肛门直肠测压以评估肛门直肠功能。