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[功能性肛门直肠疾病:相关的排粪造影结果及相关症状]

[Functional ano-rectal disorders: associated defecographic findings and related symptoms].

作者信息

Grassi R, Catalano O, Salzano A, Amitrano M, Parisi B, Rotondo A

机构信息

II Cattedra di Radiologia, Facoltà di Medicina e Chirurgia, Università Federico II, Napoli.

出版信息

Radiol Med. 1994 Jul-Aug;88(1-2):56-62.

PMID:8066256
Abstract

We retrospectively analyzed our latest 564 defecographies to evaluate: the frequency of each single defecographic finding on the total number of patients and in the two sexes; the frequency of the finding as single disorder and in association with other anorectal disorders; the correlation between findings and symptoms. The most common disorders were anterior rectocele (54%), mucosal prolapse (53%), puborectalis muscle syndrome (15%), and intussusception (15%); this order is respected in women (70, 57, 17 and 16% of the study population) but differs in men (mucosal prolapse 42%, puborectalis muscle syndrome 18%, posterior rectocele 14%, and intussusception 14%). Intussusception and puborectalis muscle syndrome were identified as an isolated finding in many cases (55% and 43%, respectively). The most common associations are: posterior rectocele with anterior rectocele (58% of cases), anterior rectocele with mucosal prolapse and vice versa (63% and 64%), intussusception with anterior rectocele (52%), puborectalis muscle syndrome with mucosal prolapse (36%) and with anterior rectocele (49%) and descending perineum syndrome with anterior rectocele (81%) and with mucosal prolapse (70%). The low rate of association among some disorders should be mentioned too for example, mucosal prolapse is associated, with intussusception only in 10% of cases. Clinical-defecographic correlations are less apparent: if some symptoms are found to be more typical of some disorders, this correlation is not pathognomonic and the clinical picture is quite aspecific. We stress the value of a careful correlation between clinical-anamnestic and defecographic findings for the correct evaluation of these disorders.

摘要

我们回顾性分析了最近的564例排粪造影,以评估:每种排粪造影结果在患者总数及男女两性中的出现频率;该结果作为单一病症以及与其他肛肠疾病相关联时的出现频率;结果与症状之间的相关性。最常见的病症为直肠前突(54%)、黏膜脱垂(53%)、耻骨直肠肌综合征(15%)和肠套叠(15%);此顺序在女性中(分别占研究人群的70%、57%、17%和16%)得到遵循,但在男性中有所不同(黏膜脱垂42%、耻骨直肠肌综合征18%、直肠后突14%和肠套叠14%)。在许多病例中,肠套叠和耻骨直肠肌综合征被确定为单一病症(分别为55%和43%)。最常见的关联为:直肠后突与直肠前突(58%的病例)、直肠前突与黏膜脱垂以及反之亦然(63%和64%)、肠套叠与直肠前突(52%)、耻骨直肠肌综合征与黏膜脱垂(36%)以及与直肠前突(49%)、会阴下降综合征与直肠前突(81%)以及与黏膜脱垂(70%)。还应提及某些病症之间的低关联率,例如,黏膜脱垂仅在10%的病例中与肠套叠相关。临床与排粪造影的相关性不太明显:如果发现某些症状在某些病症中更具典型性,这种相关性并非特异性的,并且临床表现相当不具特异性。我们强调临床病史与排粪造影结果之间仔细关联对于正确评估这些病症的价值。

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