Hamid S A, Di Lorenzo C, Reddy S N, Flores A F, Hyman P E
Department of Pediatric Gastroenterology, Miller Memorial Children's Hospital of Long Beach, California, USA.
J Pediatr Gastroenterol Nutr. 1998 Oct;27(4):398-402. doi: 10.1097/00005176-199810000-00006.
The purpose of these studies was to determine the suitability of bisacodyl for stimulating high-amplitude-propagating contractions in pediatric studies of colonic manometry.
Water-perfused manometry catheters were inserted into the right colon of children referred for evaluations related to defecation disorders. Colonic motility was measured in a 3-hour test session: an hour fasting, an hour after a meal, and 30 minutes after administration of a provocative agent.
Bisacodyl was superior to edrophonium as a stimulant for inducing high-amplitude-propagating contractions. Bisacodyl-induced high-amplitude-propagating contractions were similar in amplitude, duration, propagation velocity, and sites of origin and extinction to naturally occurring high-amplitude-propagating contractions. The effect of intrarectal bisacodyl was similar to that of intracecal bisacodyl, except for a delay of 10 minutes in onset. Bisacodyl induced high-amplitude-propagating contractions in all 28 children (22 with spontaneous high-amplitude-propagating contractions) without evidence of neuromuscular disease and in 2 of 9 children with a colonic neuromuscular disorder and no spontaneous high-amplitude-propagating contractions.
Bisacodyl-induced high-amplitude-propagating contractions were quantitatively and qualitatively similar to naturally occurring high-amplitude-propagating contractions. In selected cases, such as in children receiving total parenteral nutrition or restricted fluid intake, it may be possible to shorten diagnostic colonic manometry using bisacodyl rather than waiting for spontaneous high-amplitude-propagating contractions.
这些研究的目的是确定比沙可啶在儿童结肠测压研究中刺激高振幅传播性收缩的适用性。
将水灌注测压导管插入因排便障碍接受评估的儿童的右结肠。在3小时的测试时段内测量结肠动力：禁食1小时、进食后1小时以及给予激发剂后30分钟。
作为诱导高振幅传播性收缩的刺激剂，比沙可啶优于依酚氯铵。比沙可啶诱导的高振幅传播性收缩在幅度、持续时间、传播速度以及起始和消失部位方面与自然发生的高振幅传播性收缩相似。直肠内给予比沙可啶的效果与盲肠内给予比沙可啶相似，只是起效延迟10分钟。比沙可啶在所有28名无神经肌肉疾病证据的儿童（22名有自发性高振幅传播性收缩）以及9名患有结肠神经肌肉疾病且无自发性高振幅传播性收缩的儿童中的2名中诱导出高振幅传播性收缩。
比沙可啶诱导的高振幅传播性收缩在数量和质量上与自然发生的高振幅传播性收缩相似。在某些特定情况下，如接受全胃肠外营养或液体摄入受限的儿童中，使用比沙可啶可能有可能缩短诊断性结肠测压时间，而不必等待自发性高振幅传播性收缩出现。
