Loening-Baucke V, Yamada T
Department of Pediatrics, University of Iowa, Iowa City, USA.
Gastroenterology. 1995 Aug;109(2):397-403. doi: 10.1016/0016-5085(95)90326-7.
BACKGROUND & AIMS: Rectal sensations to balloon distention are impaired in children with chronic constipation and encopresis. The impairment of rectal sensation, which is often persistent and is related to nonrecovery, could be caused by a defect in the visceral afferent pathways. The aim of this study was to test whether the afferent pathway from the rectum is impaired in children with constipation and encopresis.
Fifteen healthy children and 15 children with constipation and encopresis were studied. Cerebral evoked potentials (EPs) were studied by averaging results of 100 rectal distentions, which used 10, 20, and 30 mL air. EPs were recorded from Cz' to Fz.
Two different types of EPs were recorded in each control subject and each child with constipation and encopresis. One EP had an early onset and showed multiple positive and negative peaks. The other EP had a much later onset and was triphasic. Early-onset EPs were recorded with significantly smaller distention volumes than the late-onset EPs. N1 and P2 latencies of the early-onset EPs and NI, PI, and NII latencies of the late-onset EPs were significantly prolonged in children with constipation and encopresis compared with controls.
The prolonged latencies suggest a defect in the afferent pathway from the rectum in children with chronic constipation and encopresis.
慢性便秘和大便失禁儿童对气囊扩张的直肠感觉受损。直肠感觉障碍通常持续存在且与未恢复有关，可能由内脏传入通路缺陷引起。本研究的目的是测试便秘和大便失禁儿童的直肠传入通路是否受损。
对15名健康儿童和15名便秘及大便失禁儿童进行研究。通过平均100次直肠扩张（使用10、20和30 mL空气）的结果来研究大脑诱发电位（EPs）。从Cz'到Fz记录EPs。
在每个对照受试者以及每个便秘和大便失禁儿童中记录到两种不同类型的EPs。一种EPs起始较早，显示多个正峰和负峰。另一种EPs起始要晚得多，呈三相。记录到起始较早的EPs时所用的扩张体积明显小于起始较晚的EPs。与对照组相比，便秘和大便失禁儿童中起始较早的EPs的N1和P2潜伏期以及起始较晚的EPs的N1、P1和N2潜伏期显著延长。
潜伏期延长表明慢性便秘和大便失禁儿童的直肠传入通路存在缺陷。
