Herbaut A G, Van de Stadt J, Panzer J M, Lalmand B, Crick D H
Department of Neurology, Hôpital Erasme, Bruxelles, Belgium.
Acta Gastroenterol Belg. 1994 Jan-Feb;57(1):13-8.
Paradoxical contraction of pelvic floor muscles during defecation straining has been said to be a cause of constipation and difficulty in passing feces. Nevertheless, controversies about its clinical significance still remained. Twenty patients with constipation and electromyographic evidence of paradoxical contraction of both puborectalis and external anal sphincter were investigated. An anorectal manometry performed in 17 confirmed the paradoxical contraction in 13 (76%). Electromyography revealed neurogenic signs in 11. Defecography demonstrated the paradoxical contraction in 6 only, but, together with barium enema and colon transit time, showed associated anorectal disorders in 9 patients. Twenty control patients were also studied. None had difficulty defecating. Nevertheless, 8 of them (40%) had paradoxical contraction. These observations suggest that paradoxical contraction of pelvic floor muscles may by asymptomatic and that another cause of emptying difficulties has always to be looked for.
排便用力时盆底肌肉的反常收缩被认为是便秘和排便困难的一个原因。然而，关于其临床意义的争议仍然存在。对20例有便秘且耻骨直肠肌和肛门外括约肌反常收缩肌电图证据的患者进行了研究。对17例患者进行的肛肠测压证实13例（76%）存在反常收缩。肌电图显示11例有神经源性体征。排粪造影仅显示6例存在反常收缩，但与钡剂灌肠和结肠传输时间一起显示9例患者存在相关的肛肠疾病。还对20例对照患者进行了研究。他们均无排便困难。然而，其中8例（40%）存在反常收缩。这些观察结果表明，盆底肌肉的反常收缩可能是无症状的，并且总是需要寻找排空困难的另一个原因。
