便秘型肠易激综合征患者结、直肠肛门动力学的临床研究

目的研究便秘型肠易激综合征患者结肠、直肠动力,直肠感觉功能.方法用结肠传输试验检测结肠传输时间,并用结肠传输指数分型,用肛门直肠测压方法测定便秘型IBS直肠静息压,肛管静息压,肛门括约肌最大缩榨压,模拟排便时,直肠收缩压,肛门括约肌剩余压,直肠对容量扩张刺激的初始感觉阈值,最大耐受容量,直肠顺应性.结果便秘型IBS患者全结肠及各节段结肠传输时间均高于对照组,便秘型IBS患者肛管静息压,直肠静息压与对照组无差异(P＞0.05),肛门括约肌最大缩榨压低于正常对照组,最大耐受容量及直肠顺应性均明显高于对照组(P＜0.01),且发现不同传输类型的便秘型IBS肛门直肠测压表现不同.结论便秘型IBS患者存在结肠、肛门直肠动力及直肠感觉功能异常,结肠传输试验与肛门直肠测压相结合,可体现不同传输类型便秘型IBS肛门直肠动力学病因机制.

A clinical study on colonic motility and anorectal manometry in constipation predominant irritable bowel syndrome

Objective To study the colonic motility, the anorectal manometry and rectal visceral perception in constipation predominant irritable bowel syndrome. Methods The cases with constipation predominant IBS and the controls were studied in a colonic transit test by radiopaque markers. Anorectal pressure and rectal visceral perception thresholds ectal compliance were mersured in patients with constipation predominant IBS and the controls. Results The total colonic transit time and segmental colonic transit time in patients with constipation predominant IBS were higher than that in controls.Anorectal resting pressure,rectal resting pressure had no significant difference between two groups(P> 0.05).Anorectal maximum squeezing pressure in patients with constipation predominant IBS was lower than that in controls (P<0.01).The maximum tolerance of the rectum and rectal compliance in constipation predominant IBS were much higher than those in the controls(P<0.01).Patients with constipation predominant IBS in different transit categories had different anorectal motility abnormalities.Conclusion Patients with constipation predominant IBS have abnormalities of colonic motility, anorectal dynamics and sensory function. Combination of colonic transit time and anorectal manometry can be better to investigate the anorectal dynamic etiology.