Lee H H, Chen S H, Chen D F, Huang C S
Department of Surgery, Cathay General Hospital, Taipei, Taiwan, R.O.C.
J Formos Med Assoc. 1994 Nov-Dec;93(11-12):944-9.
Defecographic studies were carried out in 36 females and 19 males with specific complaints of straining with defecation, incomplete rectal emptying and perineal descent. Of these, 91% had abnormal defecographic findings. Abnormalities were more common in females than in males. The female patients mean anorectal angles were 111.3 degrees (resting), 102.2 degrees (squeezing) and 124.7 degrees (straining). Their mean anterior rectocele size was 1.8 cm and the mean difference between the pelvic floor and the anorectal junction at rest and during maximal straining, the mean Ds-R, was also 1.8 cm. Ninety-one percent of the females had anterior rectoceles, 33% had internal rectal intussusception, 25% had hypertonic puborectalis slings and 22% had a Ds-R > 3 cm. The mean anorectal angles of the males were 116.3 degrees (resting), 102.0 degrees (squeezing) and 132.9 degrees (straining) and the mean Ds-R was 2.0 cm. Sixty-eight percent of the males had hypertonic puborectalis slings, 58% had internal rectal intussusception, and 42% had a Ds-R > 3 cm. All patients with hypertonic puborectalis slings had smaller, more acute straining angles. Males with abnormal perineal descent had a greater Ds-R than patients without perineal descent.
对36名女性和19名男性进行了排粪造影研究，这些患者有排便费力、直肠排空不全和会阴下降等特定主诉。其中，91%的患者有异常的排粪造影结果。异常情况在女性中比男性更常见。女性患者静息时平均肛管直肠角为111.3度，用力时为102.2度，排便时为124.7度。她们的平均直肠前突大小为1.8厘米，静息和最大用力时盆底与肛管直肠交界处的平均差值，即平均Ds-R，也为1.8厘米。91%的女性有直肠前突，33%有直肠内套叠，25%有耻骨直肠肌吊带张力过高，22%的Ds-R>3厘米。男性的平均肛管直肠角静息时为116.3度，用力时为102.0度，排便时为132.9度，平均Ds-R为2.0厘米。68%的男性有耻骨直肠肌吊带张力过高，58%有直肠内套叠，42%的Ds-R>3厘米。所有耻骨直肠肌吊带张力过高的患者排便时角度更小、更尖锐。有异常会阴下降的男性比没有会阴下降的患者Ds-R更大。
