Wald A, Chandra R, Chiponis D, Gabel S
J Pediatr Gastroenterol Nutr. 1986 May-Jun;5(3):346-51. doi: 10.1097/00005176-198605000-00002.
We compared anorectal sensory and motor functions, expulsion dynamics, and continence mechanisms in 50 children with encopresis and 21 healthy control children. When expulsion dynamics were studied, 43% of boys with encopresis inappropriately contracted the muscles near the anal canal compared with 10% of girls with encopresis (p greater than 0.05) and 10% of control children of both sexes (p less than 0.05). In contrast to previous studies we demonstrated no abnormalities of thresholds of conscious rectal sensation or internal anal sphincter relaxation. In addition, children with encopresis had no demonstrable abnormalities of rectosphincteric continence mechanisms or strength of external anal sphincter contraction. We conclude that a significant number of boys with encopresis have abnormal anorectal expulsion dynamics, which may contribute to chronic fecal retention and incontinence. Abnormalities of anorectal sensory and motor function and of rectosphincteric continence mechanisms do not seem to be important in the pathogenesis of childhood encopresis.
我们比较了50例大便失禁儿童和21例健康对照儿童的肛门直肠感觉和运动功能、排便动力学及控便机制。在研究排便动力学时，43%的大便失禁男孩肛管附近肌肉不适当收缩，相比之下，大便失禁女孩中有10%（p>0.05），两性对照儿童中有10%（p<0.05）出现这种情况。与先前研究不同，我们未发现直肠感觉阈值或肛门内括约肌松弛存在异常。此外，大便失禁儿童在直肠括约肌控便机制或肛门外括约肌收缩强度方面没有明显异常。我们得出结论，相当数量的大便失禁男孩存在异常的肛门直肠排便动力学，这可能导致慢性粪便潴留和失禁。肛门直肠感觉和运动功能以及直肠括约肌控便机制的异常在儿童大便失禁的发病机制中似乎并不重要。
