口服乳果糖对功能性便秘儿童肛门直肠压力的影响

【目的】观察功能性便秘儿童服用乳果糖口服液前后肛门直肠压力的变化,探讨乳果糖口服对儿童功能性便秘的临床疗效。【方法】收集2010年1月-2011年1月我科57例功能性便秘组儿童,予口服乳果糖治疗,疗程2周。检测治疗前后肛门直肠压力变化并随访观察症状改善情况。同期检测比较15例健康对照组儿童的肛门直肠压力情况。【结果】便秘组仅7例患儿便秘症状无明显改善,总有效率87.8%,停药后随访2周总有效率为69.4%。便秘组患儿治疗前后肛管静息压及肛管最大缩榨压与对照组无明显差异,而治疗前直肠感知阈值及直肠最大阈值较对照组明显增高(P<0.05)。便秘组口服乳果糖后直肠感知阈值(42.58±13.47)ml及直肠最大容量阈值(93.56±12.25)ml均较服药前(81.65±13.98)ml和(142.23±11.26)ml明显降低(P<0.05)。【结论】乳果糖口服可降低便秘患儿的直肠感知阈值,提高直肠敏感性,明显改善便秘症状,临床应用安全有效。

Effect of lactulose on the changes of anorectal pressure in children with functional constipation

[Objective ] To observe the changes of anorectal pressure in children with functional constipation before and after treated with lactulose, to investigate the clinical efficacy of lactulose in children. [Methods] 57 children with functional constipation were collected during Jan.2010 to Jan.2011 and all were treated with lactulose for 2 weeks. The changes of anorectal pressure and the improvement of symptom were observed. And at the same time, the anorcetal pressure of 15 healthy children were detected to investigate the difference between the healthy children and children with constipation. [ Results ] In the 57 constipation children, only 7 cases didn＇ t have obviously improvement in symptoms .The effective rate was 87.8% and decreased to 69.4% 2 weeks after drug withdrawl. There was no difference between the constipation children and healthy children in the values of anal canal maximum squeeze pressure and anal squeeze pressure. Otherwise, the rectal perception thresholds and maximum rectal volume threshold in constipation children increased significantly than that of healthy children（P 〈 0.05）. The rectal perception thresholds（42.58 ± 13.47）ml and maximum rectal volume threshold （93.56 ± 12.25）ml after lactulose decreased than the data （81.65 ± 13.98）ml and （142.23 ± 11.26）ml before use of the drug （P 〈 0.05）. [Conclusions] Lactulose can decrease the rectal perception thresholds and maximum rectal volume threshold of constipation children. It can improve the symptom of constipation and is a safety drug for treating functional constipation.