中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2009年
9期
733-736
,共4页
便秘%结肠%肛管
便祕%結腸%肛管
편비%결장%항관
Constipation%Colon%Anal canal
目的 探讨功能性便秘患者结肠和肛管直肠动力学改变及其对便秘分型、临床治疗的指导意义.方法 对我院42例老年功能性便秘患者(CFC)及20例健康对照者,采用不透X线标记物法测定结肠通过时间(CTT),同时应用8通道水灌注式下消化道压力检测系统进行直肠、肛管动力学测定.结果 (1)老年CFC组全结肠通过时间及乙状结肠通过时间分别为(49.0±16.4)h和(20.1±13.5)h,较对照组(25.2±7.7)h和(7.8±4.1)h明显延长(t=6.16和t=3.97,均P<0.05);(2)老年CFC患者模拟排便时肛管压力为(39.6±15.7)mmHg,对照组为(17.6±9.3)mmHg,两组比较差异有统计学意义(t=5.79,P<0.05),老年CFC组13例患者模拟排便时出现肛管压力反常升高;老年CFC组直肠初始感觉阈和最大耐受容量分别为(49.2±10.5)ml和(175.2±52.6)ml,高于对照组的(33.6±8.5)ml和(123.4±39.1)ml,差异均有统计学意义(t=5.79和t=3.91,均P<0.05);直肠肛门抑制反射松弛率两组分别为59.5%和85.0%(x2=4.03,P<O.05).结论 老年CFC患者结肠通过时间延长,且以乙状结肠通过时间延长为主;肛管直肠动力学改变包括直肠敏感性降低、直肠肛门抑制反射减弱及排便时直肠肛管运动不协调等;结肠通过时间的测定、肛管直肠测压为临床分型及选择正确的治疗方法提供了依据,对临床具有指导意义.
目的 探討功能性便祕患者結腸和肛管直腸動力學改變及其對便祕分型、臨床治療的指導意義.方法 對我院42例老年功能性便祕患者(CFC)及20例健康對照者,採用不透X線標記物法測定結腸通過時間(CTT),同時應用8通道水灌註式下消化道壓力檢測繫統進行直腸、肛管動力學測定.結果 (1)老年CFC組全結腸通過時間及乙狀結腸通過時間分彆為(49.0±16.4)h和(20.1±13.5)h,較對照組(25.2±7.7)h和(7.8±4.1)h明顯延長(t=6.16和t=3.97,均P<0.05);(2)老年CFC患者模擬排便時肛管壓力為(39.6±15.7)mmHg,對照組為(17.6±9.3)mmHg,兩組比較差異有統計學意義(t=5.79,P<0.05),老年CFC組13例患者模擬排便時齣現肛管壓力反常升高;老年CFC組直腸初始感覺閾和最大耐受容量分彆為(49.2±10.5)ml和(175.2±52.6)ml,高于對照組的(33.6±8.5)ml和(123.4±39.1)ml,差異均有統計學意義(t=5.79和t=3.91,均P<0.05);直腸肛門抑製反射鬆弛率兩組分彆為59.5%和85.0%(x2=4.03,P<O.05).結論 老年CFC患者結腸通過時間延長,且以乙狀結腸通過時間延長為主;肛管直腸動力學改變包括直腸敏感性降低、直腸肛門抑製反射減弱及排便時直腸肛管運動不協調等;結腸通過時間的測定、肛管直腸測壓為臨床分型及選擇正確的治療方法提供瞭依據,對臨床具有指導意義.
목적 탐토공능성편비환자결장화항관직장동역학개변급기대편비분형、림상치료적지도의의.방법 대아원42례노년공능성편비환자(CFC)급20례건강대조자,채용불투X선표기물법측정결장통과시간(CTT),동시응용8통도수관주식하소화도압력검측계통진행직장、항관동역학측정.결과 (1)노년CFC조전결장통과시간급을상결장통과시간분별위(49.0±16.4)h화(20.1±13.5)h,교대조조(25.2±7.7)h화(7.8±4.1)h명현연장(t=6.16화t=3.97,균P<0.05);(2)노년CFC환자모의배편시항관압력위(39.6±15.7)mmHg,대조조위(17.6±9.3)mmHg,량조비교차이유통계학의의(t=5.79,P<0.05),노년CFC조13례환자모의배편시출현항관압력반상승고;노년CFC조직장초시감각역화최대내수용량분별위(49.2±10.5)ml화(175.2±52.6)ml,고우대조조적(33.6±8.5)ml화(123.4±39.1)ml,차이균유통계학의의(t=5.79화t=3.91,균P<0.05);직장항문억제반사송이솔량조분별위59.5%화85.0%(x2=4.03,P<O.05).결론 노년CFC환자결장통과시간연장,차이을상결장통과시간연장위주;항관직장동역학개변포괄직장민감성강저、직장항문억제반사감약급배편시직장항관운동불협조등;결장통과시간적측정、항관직장측압위림상분형급선택정학적치료방법제공료의거,대림상구유지도의의.
Objective To investigate the dynamic abnormality of colon and anorectum in elderly patients with chronic functional constipation(CFC). Methods Forty-two elderly patients with CFC and twenty elderly healthy controls were selected. Total and segmental colonic transit time(CTT) were assessed radiographically by using oral radiopaque markers. Eight-lead water perfusion pressure measurement system and balloon were used to test the pressure and the perception threshold values of anus and rectum. Results (1) Total colonic transit time (TCTT) and sigmoid-rectum transit time (SRTT) were (49.0±16.4) h and (20.1±13.5) h in elderly patients with CFC, which were significantly prolonged compared with the controls [(25.2±7.7) h and (7.8±4.1) h, t=6.16 and 3.97,both P<0.05]. (2) The pressure of anal canal during defecation was (39.6±15.7) mmHg in elderly patients with CFC and (17.6±9.3) mm Hg in controls (t=5.79, P<O.05). The lowest volume threshold and the maximal tolerance volume of rectal perception to balloon distention were (49.2±10.5) ml and (175.2±52.6) ml in elderly patients with CFC, which were higher than the controls[(33.6±8.5) ml and (123.4±39.1) ml, t=5.79 and 3.91, both P<0.05]. The rate of rectoanal inhibitory reflex (RAIR) was 59.5% and 85.0% in elderly patients with CFC and controls, respectively(x2 =4.03,P<O.05). Conclusions The CTT and SRTT are prolonged obviously in elderly patients with CFC. The anorectal dynamic changes include decreased sensibility of rectum, lower rate of RAIR and anorectal dyssynergia during defecation. The test of CTT and anorectal manometry provide evidence for the classification and treatment of constipation.
