Farouk R, Duthie G S, MacGregor A B, Bartolo D C
Department of Surgery, Royal Infirmary, Edinburgh, UK.
Br J Surg. 1994 May;81(5):743-6. doi: 10.1002/bjs.1800810542.
Thirty-five patients with complete rectal prolapse, 32 with neurogenic faecal incontinence and 33 controls underwent ambulatory recording using a computerized anal electromyographic and anorectal manometry system. Median resting anal pressures were 34 cmH2O in patients with prolapse, 51 cmH2O in those with neurogenic faecal incontinence and 94 cmH2O in controls. Median basal rectal pressures were 18, 21 and 21 cmH2O respectively. High-pressure rectal waves of median amplitude 71 cmH2O lasting 30-150 s and associated with inhibition of the electromyographic activity of the internal and sphincter and a fall in anal pressures were seen in all patients with prolapse but not in controls or those with neurogenic incontinence. These waves were abolished following successful resection rectopexy. Recovery of continence occurs by abolition of high-pressure rectal waves, which produce maximal inhibition of sphincter activity before operation.
35例完全性直肠脱垂患者、32例神经源性大便失禁患者和33例对照者使用计算机化肛门肌电图和肛肠测压系统进行动态记录。脱垂患者静息肛门压力中位数为34 cmH₂O，神经源性大便失禁患者为51 cmH₂O，对照者为94 cmH₂O。基础直肠压力中位数分别为18、21和21 cmH₂O。所有直肠脱垂患者均可见中位振幅71 cmH₂O、持续30 - 150秒、与内括约肌和括约肌肌电图活动抑制及肛门压力下降相关的高压直肠波，而对照者和神经源性失禁患者未见。成功的直肠切除固定术后，这些波消失。通过消除高压直肠波实现控便恢复，高压直肠波在手术前会对括约肌活动产生最大抑制。
