Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States of America.
Division of Gastroenterology and Hepatology, University of Michigan Hospitals and Health Centers, Ann Arbor, MI, United States of America.
PLoS One. 2020 Sep 29;15(9):e0228761. doi: 10.1371/journal.pone.0228761. eCollection 2020.
There is a need for a lower cost manometry system for assessing anorectal function in primary and secondary care settings. We developed an index finger-based system (termed "digital manometry") and tested it in healthy volunteers, patients with chronic constipation, and fecal incontinence. Anorectal pressures were measured in 16 participants with the digital manometry system and a 23-channel high-resolution anorectal manometry system. The results were compared using a Bland-Altman analysis at rest as well as during maximum squeeze and simulated defecation maneuvers. Myoelectric activity of the puborectalis muscle was also quantified simultaneously using the digital manometry system. The limits of agreement between the two methods were -7.1 ± 25.7 mmHg for anal sphincter resting pressure, 0.4 ± 23.0 mmHg for the anal sphincter pressure change during simulated defecation, -37.6 ± 50.9 mmHg for rectal pressure changes during simulated defecation, and -20.6 ± 172.6 mmHg for anal sphincter pressure during the maximum squeeze maneuver. The change in the puborectalis myoelectric activity was proportional to the anal sphincter pressure increment during a maximum squeeze maneuver (slope = 0.6, R2 = 0.4). Digital manometry provided a similar evaluation of anorectal pressures and puborectalis myoelectric activity at an order of magnitude less cost than high-resolution manometry, and with a similar level of patient comfort. Digital Manometry provides a simple, inexpensive, point of service means of assessing anorectal function in patients with chronic constipation and fecal incontinence.
在初级和二级保健环境中评估肛肠功能需要一种成本更低的测压系统。我们开发了一种基于食指的系统（称为“数字测压法”），并在健康志愿者、慢性便秘患者和粪便失禁患者中进行了测试。使用数字测压系统和 23 通道高分辨率肛肠测压系统测量了 16 名参与者的肛肠压力。在静息状态以及最大收缩和模拟排便动作期间，使用 Bland-Altman 分析比较了两种方法的结果。同时，使用数字测压系统还同时量化了耻骨直肠肌的肌电活动。两种方法之间的一致性界限为：肛门括约肌静息压力为-7.1 ± 25.7mmHg，模拟排便时肛门括约肌压力变化为 0.4 ± 23.0mmHg，模拟排便时直肠压力变化为-37.6 ± 50.9mmHg，最大收缩动作时肛门括约肌压力为-20.6 ± 172.6mmHg。耻骨直肠肌肌电活动的变化与最大收缩动作期间肛门括约肌压力的增量成正比（斜率=0.6，R2=0.4）。数字测压法在成本上比高分辨率测压法低一个数量级，提供了类似的肛肠压力和耻骨直肠肌肌电活动评估，并且具有相似的患者舒适度。数字测压法为慢性便秘和粪便失禁患者提供了一种简单、经济、即时的评估肛肠功能的方法。
