Bannister J J, Timms J M, Barfield L J, Donnelly T C, Read N W
Int J Colorectal Dis. 1986 Jul;1(3):175-82. doi: 10.1007/BF01648446.
Manometric, radiological and neurophysiological investigations were performed on 34 women, aged between 14 and 53, who suffered with chronic constipation refractory to treatment, and on 27 age-matched normal female control subjects. The constipated patients had more difficulty in evacuating simulated stools than control subjects and 13 out of 19 patients tested obstructed defaecation by contracting the external sphincter during straining. The constipated group required a greater degree of rectal distension than control subjects to induce rectal contractions, anal relaxation and a desire to defaecate. Other modalities of rectal sensation were normal in the constipated subjects. Compared with controls, constipated patients had significantly lower anal pressures, an abnormal degree of perineal descent on straining and an obtuse anorectal angulation at rest. These results were compatible with weakness of the pelvic floor and neuropathic damage to the external sphincter. Mouth to anus transit time was abnormally prolonged in 60% of constipated patients, but was within the normal range in the remainder. Anorectal function in patients with slow transit was not significantly different from that in patients with a normal transit time. The mouth to caecum transit time of a standard meal was prolonged in constipated patients irrespective of the duration of the whole gut transit. Gastric emptying was not significantly prolonged.
对34名年龄在14至53岁之间、患有慢性难治性便秘的女性以及27名年龄匹配的正常女性对照者进行了测压、放射学和神经生理学检查。便秘患者在排出模拟粪便时比对照者更困难，在接受测试的19名患者中，有13名在用力排便时通过收缩外括约肌导致排便梗阻。与对照者相比，便秘组需要更大程度的直肠扩张才能诱发直肠收缩、肛门松弛和排便欲望。便秘患者的其他直肠感觉方式正常。与对照者相比，便秘患者的肛门压力明显较低，用力排便时会阴下降程度异常，静息时肛管直肠角钝。这些结果与盆底肌无力和外括约肌神经病变相符。60%的便秘患者口至肛门传输时间异常延长，但其余患者在正常范围内。慢传输型患者的肛管直肠功能与传输时间正常的患者无明显差异。无论全肠道传输时间长短，便秘患者标准餐的口至盲肠传输时间均延长。胃排空未明显延长。
