直肠肛门反射及其对特发性便秘的诊断价值

目的研究直肠肛门反射(RAR)对特发性便秘(CIC)的诊断意义。方法用直肠肛管测压法检测30位正常人和32例特发性便秘患者直肠肛门反射曲线的肛门外括约肌收缩压(EASCP)、肛门内括约肌舒张压(IASDP)、肛门外括约肌收缩压与肛门内括约肌舒张压的压力差(PD)、反射时间(RT)包括直肠肛门收缩反射时间(RACRT)和直肠肛门抑制反射时间(RAIRT)6项技术指标。结果30位正常人均能导引直肠肛门反射,32例特发性便秘患者的EASCP、IASDP、PD、RAIRT和直肠肛门反射时间(RART)均明显小于正常组,两组间差异有非常显著性意义(P<0.01)。结论特发性便秘患者的直肠肛门反射、直肠肛门收缩反射、直肠肛门抑制反射均比正常人明显减弱,与直肠肛管压力变化高度相关,以肛门内括约肌舒张功能失调为主要病理改变。

Rectoanal reflex examination and its diagnostic value in chronic idiopathic constipation

Objectives To measure rectoanal reflex (RAR) and analyze its diagnostic value in chronic idiopathic constipation (CIC). Methods Rectoanal pressure measurement was performed on 30 normal volunteers and 32 cases of CIC. The indexes such as external anal sphincter contractile pressure (EASCP) internal anal sphincter diastolic pressure (IASDP),their pressure difference (PD), and reflex time(RT) including rectoanal contraction reflex time(RACRT) and rectoanal inhibition reflex time (RAIRT), were measured. Results Thirty normal people got normal RAR. In CIC cases,the indexes such as EASCP,IASDP,PD,RAIRT and RART were smaller than those in normal group, there was significant difference between the two groups (P< 0.01). Conclusions As compared with normal people, RAR, RACR and RAIR in CIC patients become weaker, and are related to the rectoanal pressure variations. The main pathologic change is internal anal sphincter diastolic dysfunction.