便秘患者与正常人排粪造影的对比研究

目的：探讨便秘患者与正常人排粪造影的X线表现,并分析便秘的原因。方法：对109例便秘患者及55例正常人进行排粪造影检查,分别在静坐、力排时对肛直角、肛上距、肠耻距、直肠骶前间隙、直肠前突深度进行测量,并观察直肠黏膜相及有无直肠黏膜脱垂及直肠内套叠。结果：便秘患者组异常表现出现率高于正常人组,经统计学分析,盆底痉挛综合征、会阴下降、内脏下垂、多种功能性出口梗阻异常有显著性（P〈0.05）,而轻、中度直肠前突及直肠黏膜脱垂及直肠内套叠差异无显著性（P〉0.05）;在109例便秘患者组中,盆底痉挛综合征出现率男组（15/29）高于女组（11/80）,多种功能性出口梗阻异常并存出现率男组（2/29）低于女组（44/80）,经统计学分析差异有显著性（P〈0.001）。结论：排粪造影异常表现也可在正常人中显示,盆底痉挛综合征可能是男性患者便秘的主要原因,多种功能性出口梗阻异常并存可能是女性患者便秘的主要原因;直肠前突、直肠黏膜脱垂、直肠内套叠等单独出现,特别是程度较轻时,并不能导致便秘。

A Comparative Study on Defecography between Constipation Patients and Normal People

Objective： To investigate X-ray appearance differences of defecography between constipation patients and normal people and to analyze the cause of constipation. Methods： Defecography was performed to 109 constipation patients （patient group, group P） and 55 normal people （control group, group C）, and the following items were measured in both rest phase and defecation phase： anorectal angle （ARA）, distance between anorectal junction （the upper part of anal canal） and the pubococcygeal line （DUAC）, distance between intestines and pubococcygeal fine （DIPC）, presacral space of rectum （PSR）, and depth of rectum anterior process （DRAP）. At same time, observation was made on rectal mucosa phase, rectal mucosal prolapse （RMP）, and intrarectal intussusception （IRI）, if there was some. Results： Frequency of abnormity was higher in group P than in group C. The statistical incidence differences of spastic pelvic floor syndrome （SPFS）, perineum descend （PD）, visceroptosis, and multi-functional export obstruction （MFEO） were significant between groups P and C （ P 〈 0.05 ）. No significant difference was found in incidences of mild and midrange rectum protrution （RP）, RMP and IRI between the 2 groups （P 〉 0. 05）. Among the 109 constipation patients, the SPFS incidence in men （15/29） was higher than that in women （11/80）,while MFEO incidence in men （2/29） was lower than that in women （44/80）, and the difference was significant（P 〈0. 001 ）. Conclusions： Abnormal appearances of defecography can be seen in normal people; SPFS might be the main cause of constipation in men, while the main cause of constipation in women is MFEO; Solitary occurrence of RP, RMP, or IRI, especially in mild cases, may not lead to constipation.