Sainio P
Acta Chir Scand. 1985;151(8):695-700.
Anorectal function was manometrically studied in 199 adults on average 9 years after laying open of anal fistula, in order to determine the factors adversely affecting anal continence. Resting anal pressure, and especially squeeze and voluntary contraction pressures, were significantly reduced in the 67 patients with defective anal control. Maximal squeeze and contractile pressures were significantly lower in women than in men but, like maximal resting pressure, were uninfluenced by age. Fistula type significantly influenced maximal resting and squeeze pressures, with tendency to low pressures and high incidence of defective anal control after operation for high intermuscular fistula. Maximal contractile power was unrelated to extent of external sphincter division. Rectal sensation and activity of the rectoanal reflexes did not appreciably differ between the continent patients and the others. Digital assessment of sphincter tone at rest and at maximal contraction correlated well with the respective anal pressures, but was an unreliable indicator of anal continence. The manometric findings warrant maximal preservation of the anal sphincter musculature, but fistula healing must not be thereby endangered.
为了确定对肛门节制产生不利影响的因素，对199名肛瘘切开术后平均9年的成年人进行了肛门直肠功能测压研究。67例肛门控制功能有缺陷的患者，其静息肛门压力，尤其是挤压和随意收缩压力显著降低。女性的最大挤压和收缩压力显著低于男性，但与最大静息压力一样，不受年龄影响。瘘管类型对最大静息和挤压压力有显著影响，高位肌间瘘手术后肛门控制功能不良的发生率较高且压力有降低趋势。最大收缩力与外括约肌切断范围无关。在控便患者和其他患者之间，直肠感觉和直肠肛门反射活动没有明显差异。静息和最大收缩时通过手指评估括约肌张力与相应的肛门压力相关性良好，但不是肛门节制的可靠指标。测压结果表明应最大限度地保留肛门括约肌肌肉组织，但不能因此危及瘘管愈合。
