大便失禁-便秘儿童的肛门直肠测压检查

Anorectal manometric examination in encopretic-constipated children.

作者信息

Sutphen J, Borowitz S, Ling W, Cox D J, Kovatchev B

机构信息

University of Virginia Health Sciences Center, Department of Pediatrics, Charlottesville 22901, USA.

出版信息

Dis Colon Rectum. 1997 Sep;40(9):1051-5. doi: 10.1007/BF02050928.

DOI:10.1007/BF02050928

PMID:9293934

Abstract

PURPOSE

We have investigated the use of anorectal manometry to distinguish encopretic-constipated children (n = 88) from sibling controls (n = 16) and nonsibling controls (n = 11).

METHODS

Study variables included manometrically determined resting and maximum voluntary anal sphincter pressure, depth and speed of rectoanal inhibitory reflex, minimum rectal volume sensation, critical distending volume for fecal urgency, rectal and anal pressure responses during attempted defecation, and ability to defecate a water-filled balloon.

RESULTS

Change in anal sphincter pressure during attempted defecation (P = 0.03), gradient between rectal and sphincter pressure during attempted defecation (P = 0.02), critical distending volume for fecal urgency (P = 0.02), and ability to defecate a water-filled balloon (P = 0.05) distinguished encopretic-constipated from control children. The change in rectal pressure associated with the rectoanal inhibitory reflex just escaped significance at P = 0.07.

CONCLUSIONS

Anal sphincter spasm and megacolon are pathophysiologic abnormalities associated with pediatric constipation-encopresis.

摘要

目的

我们研究了使用肛门直肠测压法来区分患有大便失禁性便秘的儿童（n = 88）与同胞对照儿童（n = 16）以及非同胞对照儿童（n = 11）。

方法

研究变量包括通过测压法测定的静息和最大自主肛门括约肌压力、直肠肛门抑制反射的深度和速度、最小直肠容量感觉、引起便急的临界扩张容量、排便尝试期间的直肠和肛门压力反应以及排出充水球囊的能力。

结果

排便尝试期间肛门括约肌压力的变化（P = 0.03）、排便尝试期间直肠与括约肌压力之间的梯度（P = 0.02）、引起便急的临界扩张容量（P = 0.02）以及排出充水球囊的能力（P = 0.05）可区分大便失禁性便秘儿童与对照儿童。与直肠肛门抑制反射相关的直肠压力变化在P = 0.07时刚刚未达到显著水平。