Siproudhis L, Le Gall R, Ropert A, Reignier A, Heresbach D, Raoul J L, Renet C, Bretagne J F, Gosselin M
Service d'Hépato-Gastroentérologie, Hôpital Pontchaillou, Rennes.
Gastroenterol Clin Biol. 1993;17(3):162-7.
Adults with dyschezia are occasionally diagnosed as having megarectum when anorectal manometry identifies rectal sensory disturbances. It remains difficult however to ascertain whether this state represents a part of the pathophysiological process responsible for symptoms, or just an associated phenomenon. The aim of this study was to highlight the symptomatic and functional features encountered in patients with dyschezia and megarectum, and to compare them with those obtained in an asymptomatic group and in a group of patients complaining of dyschezia without manometric megarectum.
The maximum tolerable volume (MTV) was defined as the highest tolerable volume which induced painful and irrepressible repletion upon inflation of the rectum with air. The upper normal range of MTV (330 mL) was obtained from rectal manometry performed in a group of 18 healthy volunteers and asymptomatic patients (mean age: 37.8 +/- 14 years, 12 F, 6 M). Between February 90 and February 92, 27 consecutive adults (48 ans +/- 15 years, 26 F, 1 M) suffering from dyschezia were found to have abnormally increased MTV, and were compared to a group of 35 patients (47 +/- 15.3 years, 34 F, 1 M) with dyschezia with MTV within normal ranges. Symptomatic patients underwent detailed interrogation, clinical examination, anorectal manometry, and evacuation proctography.
Parity, prevalence of hysterectomy, symptoms and natural history did not differ between the two groups except for increased use of antidepressive agents in the megarectum group.(ABSTRACT TRUNCATED AT 250 WORDS)
排便困难的成年人在肛门直肠测压发现直肠感觉障碍时，偶尔会被诊断为巨直肠。然而，仍难以确定这种状态是导致症状的病理生理过程的一部分，还是仅仅是一种相关现象。本研究的目的是突出排便困难和巨直肠患者所遇到的症状和功能特征，并将其与无症状组以及一组抱怨排便困难但测压无巨直肠的患者的特征进行比较。
最大耐受容量（MTV）定义为向直肠充气时引起疼痛且无法抑制的胀满感的最高耐受容量。MTV的正常上限（330毫升）来自对一组18名健康志愿者和无症状患者（平均年龄：37.8±14岁，12名女性，6名男性）进行的直肠测压。在1990年2月至1992年2月期间，连续发现27名患有排便困难的成年人（年龄48±15岁，26名女性，1名男性）MTV异常增加，并与35名排便困难但MTV在正常范围内的患者（年龄47±15.3岁，34名女性，1名男性）进行比较。有症状的患者接受了详细询问、临床检查、肛门直肠测压和排粪造影检查。
除了巨直肠组使用抗抑郁药的比例增加外，两组之间的 parity、子宫切除术患病率、症状和自然病史没有差异。（摘要截断于250字）
