首页|功能性便秘患者的直肠肛门抑制反射特征分析100例

功能性便秘患者的直肠肛门抑制反射特征分析100例

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目的:利用高分辨率肛门直肠测压技术探讨功能性便秘患者的肛门直肠动力学、直肠感觉功能及神经反射功能的特点。方法:选取100例功能性便秘患者和100例健康志愿者，通过高分辨率肛门直肠测压比较肛门静息压、最大缩榨压、直肠排便压、肛管残余压、初始感觉阈值、初始排便阈值、最大容量的感觉阈值和直肠肛门抑制反射（RAIR）等相关参数的差异。同时进一步比较不同分型之间功能性便秘患者RAIR相关参数的差异。结果:功能性便秘患者与健康志愿者相比，在初始感觉阈值、初始便意阈值、最大容量感觉阈值、直肠抑制反射、RAIR残余压、RAIR松弛率和RAIR松弛时间［（37.74±20.89）mmHg：（24.45±11.55）mmHg、（68.31±25.53）ml：（52.22±19.02）ml、（152.32±55.87）ml：（138.22±41.28）ml、（16.90±8.12）ml：（11.90±4.42）ml、（31.08±18.84）mmHg：（20.30±12.13）mmHg、（34.61±18.81）%：（57.41±20.28）%、（8.30±5.41）s：（14.89±3.73s），差异具有统计学意义（P＜0.05）；在肛门静息压、最大缩榨压、直肠排便压、肛管残余压［（70.62±22.28）mmHg：（69.80±15.19）mmHg、（132.61±39.94）mmHg：（141.41±39.91）mmHg、（46.24±24.10）mmHg：（51.51±44.61）mmHg、（81.29±27.34）mmHg：（77.55±25.25）mmHg］差异无统计学意义（P＞0.05）。结论:功能性便秘患者普遍存在直肠感觉功能减退、直肠抑制反射（RAIR）异常，提示神经通路异常是功能性便秘发生的主要机制之一。
Characteristics of recoanal inhibitory reflex in patients with functional constipation: analysis of 100 cases
Objective:To explore the characteristics of anorectal dynamics, rectal sensory function, and nerve reflex function in patients with functional constipation by high-resolution anorectal manometry.Methods:One hundred functional constipation patients and 100 healthy volunteers were selected to compare their differences in anal resting pressure, maximum compressive pressure, rectal defecation pressure, anal residual pressure, initial sensory threshold, initial defecation threshold, maximum volume sensory threshold, and recoanal inhibitory reflex (RAIR) related parameters by high-resolution anorectal manometry. The differences in RAIR related parameters among patients with different subtypes of functional constipation were also compared.Results:Compared with healthy volunteers, patients with functional constipation had significantly higher initial sensory threshold, initial defecation threshold, maximum volume sensory threshold, RAIR, RAIR residual pressure, RAIR relaxation rate, and RAIR relaxation time [(37.74±20.89) mmHg vs (24.45±11.55) mmHg, (68.31±25.53) ml vs (52.22±19.02) ml, (152.32±55.87) ml vs (138.22±41.28) ml, (16.90±8.12) ml vs (11.90±4.42) ml, (31.08±18.84) mmHg vs (20.30±12.13) mmHg, (34.61±18.81)% vs (57.41±20.28)%, and (8.30±5.41) s vs (14.89±3.73) s, respectively, P＜0.05], while there was no significant difference in anal resting pressure, maximum compressive pressure, rectal pressure, or anal residual pressure [(70.62±22.28) mmHg vs (69.80±15.19) mmHg, (132.61±39.94) mmHg vs (141.41±39.91) mmHg, (46.24±24.10) mmHg vs (51.51±44.61) mmHg, and (81.29±27.34) mmHg vs (77.55±25.25) mmHg, P＞0.05] between them.Conclusion:Rectal hypoesthesia and abnormal RAIR are common in patients with functional constipation, suggesting that abnormal neural pathway is one of the main mechanisms of functional constipation.

郑秀丽、倪敏

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210000　江苏南京，南京市中医院肛肠科

功能性便秘 高分辨率肛门直肠测压 直肠肛门抑制反射

江苏省重点研发计划(社会发展)项目

BE2018612

2023

10.3877/cma.j.issn.1674-0785.2023.08.005

中华临床医师杂志(电子版)
中华医学会

中华临床医师杂志(电子版)

CSTPCD
影响因子：0.99
ISSN：1674-0785
年,卷(期)：2023.17(8)
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