Kubota M, Suita S, Kamimura T
Department of Pediatric Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Surg Today. 1997;27(7):632-7. doi: 10.1007/BF02388220.
The integrity of the sensory nervous system in the anal canals of chronically constipated children was investigated using evoked potential techniques examining cerebral and spinal evoked potentials from the lower extremities and anal canal. Stimulation of the posterior tibial nerve produced no significant difference in the parameters of spinal and cerebral evoked potentials between 18 controls and 12 chronically constipated children. However, stimulation of the anal canal resulted in evoked potentials related to the age and/or consciousness level of the control children. Reproducible cerebral responses were obtained only from nine of these control children, all aged over 4 years, who were examined while awake without sedatives. A typical response was characterized by a polyphasic wave occurring with an onset latency of 79.4 +/- 27.7 ms (mean +/- SD). In the 12 chronically constipated children, the 5 sedated patients examined while asleep did not show any reproducible potential, as in the controls. However, in the remaining 7 children examined while awake, the occurrence of the anal canal evoked potential was significantly reduced, and only two exhibited a cerebral response. These findings suggest that rectal mucosal perception of the intraluminal stimuli might be disturbed in some children with chronic constipation.
利用诱发电位技术，通过检测下肢和肛管的脑诱发电位与脊髓诱发电位，对慢性便秘儿童肛管内感觉神经系统的完整性进行了研究。刺激胫后神经时，18名对照组儿童和12名慢性便秘儿童的脊髓和脑诱发电位参数无显著差异。然而，刺激肛管会产生与对照组儿童年龄和/或意识水平相关的诱发电位。仅在9名年龄超过4岁的对照组儿童中获得了可重复的脑反应，这些儿童在未使用镇静剂的清醒状态下接受检查。典型反应的特征是出现多相波，起始潜伏期为79.4 +/- 27.7毫秒（平均值 +/- 标准差）。在12名慢性便秘儿童中，5名在睡眠状态下接受检查的镇静患者与对照组一样，未显示出任何可重复的电位。然而，在其余7名清醒状态下接受检查的儿童中，肛管诱发电位的出现明显减少，只有两名儿童表现出脑反应。这些发现表明，在一些慢性便秘儿童中，直肠黏膜对腔内刺激的感知可能受到干扰。
