Cucchiara S, Coremans G, Staiano A, Corazziari E, Romaniello G, Di Lorenzo C, Tamburrini O, Auricchio S
J Pediatr Gastroenterol Nutr. 1984 Sep;3(4):545-50. doi: 10.1097/00005176-198409000-00012.
Fifty-three children with chronic idiopathic constipation, 32 with fecal soiling and 21 without soiling, were investigated by total gastrointestinal transit time (TGITT) and anorectal manometry (ARM). TGITT and ARM were also performed, respectively, in 46 and 32 healthy subjects. Twenty-two of the 32 children with soiling were successfully managed by medical treatment and toilet training. TGITT was significantly longer in all constipated children than in normal children. Furthermore, some parameters of anorectal motility (threshold volume, amplitude of threshold inhibitory anal reflex) of the patients differed markedly from those measured in controls. Rectal compliance was significantly higher in children with fecal soiling than in children with constipation without soiling and healthy controls. In the successfully treated children, soiling disappeared, TGITT normalized, and anorectal variables changed significantly. It is concluded that TGITT is useful in assessing the degree of constipation. Electromanometry of the anorectum is of great help in the diagnosis of functional constipation by excluding aganglionosis; furthermore, it provides additional information allowing better understanding of the mechanisms involved in functional constipation in children.
对53例慢性特发性便秘患儿进行了研究，其中32例有大便失禁，21例无大便失禁，采用全胃肠通过时间（TGITT）和肛门直肠测压（ARM）进行检查。还分别对46名健康受试者和32名健康受试者进行了TGITT和ARM检查。32例大便失禁患儿中有22例通过药物治疗和排便训练成功治愈。所有便秘患儿的TGITT均显著长于正常儿童。此外，患者的一些肛门直肠运动参数（阈值容量、阈值抑制性肛门反射幅度）与对照组测量的参数明显不同。有大便失禁的儿童直肠顺应性显著高于无大便失禁的便秘儿童和健康对照组。在成功治疗的儿童中，大便失禁消失，TGITT恢复正常，肛门直肠变量显著改变。结论是TGITT有助于评估便秘程度。肛门直肠测压法通过排除神经节细胞减少症，对功能性便秘的诊断有很大帮助；此外，它还提供了额外的信息，有助于更好地理解儿童功能性便秘的发病机制。
