Miller R, Bartolo D C, Cervero F, Mortensen N J
Br J Surg. 1987 Jun;74(6):511-5. doi: 10.1002/bjs.1800740632.
In the skin, temperature sensation plays an important role in discriminating between gas, liquid and solid. To elucidate the role of temperature sensation in idiopathic faecal incontinence we studied the minimum detectable temperature change in the lower, middle and upper zones of the anal canal and rectum in 33 normal subjects, and 20 patients with idiopathic faecal incontinence. A water perfused thermode was used to vary anorectal temperature from 37 degrees C down to 32.5 degrees C and up to 41.5 degrees C. The temperature change was reported by the patient as the thermode temperature varied from 37 degrees C to each extreme and on return to base line. The anal canal in the control group was highly sensitive to temperature change, the lower rectum was significantly less sensitive (P less than 0.0001). At each level in the anal canal and lower rectum the incontinent group were significantly less sensitive than their controls (P less than 0.005). The mid-rectum had no appreciable sensation in either group. We consider that this sensory deficit may be an important factor in idiopathic faecal incontinence.
在皮肤中，温度感觉在区分气体、液体和固体方面起着重要作用。为了阐明温度感觉在特发性大便失禁中的作用，我们研究了33名正常受试者和20名特发性大便失禁患者肛管及直肠下、中、上区域的最小可检测温度变化。使用水灌注式温度探头将肛管直肠温度从37℃降至32.5℃，再升至41.5℃。当温度探头温度从37℃变化到每个极值并返回基线时，由患者报告温度变化情况。对照组的肛管对温度变化高度敏感，直肠下部的敏感性明显较低（P<0.0001）。在肛管和直肠下部的每个水平，失禁组的敏感性均明显低于对照组（P<0.005）。两组的直肠中部均无明显感觉。我们认为这种感觉缺陷可能是特发性大便失禁的一个重要因素。
