Iwai N, Yanagihara J, Tokiwa K, Deguchi E, Takahashi T
Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Japan.
J Pediatr Surg. 1988 May;23(5):393-7. doi: 10.1016/s0022-3468(88)80433-0.
Electromyography (EMG) and measurement of voluntary contraction pressure of the external sphincter muscle were performed in 28 patients, aged 5 to 14 years, to assess the function of the external sphincter after surgical correction of anorectal malformations. Ten normal children, aged 5 to 15 years, served as controls. External sphincter function in patients with high-type anomalies was disturbed in the areas of tonic activity, inflation reflex, and activity during further rectal filling. In patients with low-type or intermediate-type anomalies, function was preserved and was equal to that in normal controls. Phasic activity was observed in patients with all types of anomalies and in normal subjects. Among those with high-type anomalies, the three patients with Kelly's score of less than 2 had voluntary contractions of 20 cmH2O or less. However, the mean voluntary contraction pressures were not significantly different among the three types of anomalies. Therefore, patients with high-type anomalies may acquire compensatory voluntary continence through bowel training.
对28例年龄在5至14岁的患者进行了肌电图（EMG）检查和外括约肌自主收缩压力测量，以评估肛门直肠畸形手术矫正后外括约肌的功能。10名年龄在5至15岁的正常儿童作为对照。高位型畸形患者的外括约肌功能在紧张性活动、膨胀反射及直肠进一步充盈时的活动方面受到干扰。低位型或中间型畸形患者的功能得以保留，且与正常对照相同。在所有类型畸形患者及正常受试者中均观察到了阶段性活动。在高位型畸形患者中，凯利评分低于2分的3例患者自主收缩压力为20 cmH2O或更低。然而，三种类型畸形患者的平均自主收缩压力并无显著差异。因此，高位型畸形患者可能通过排便训练获得代偿性自主控便能力。
