论文部分内容阅读
目的:通过对不同类型功能性便秘(FC)患者肛门直肠动力和感觉功能的研究,比较不同类型FC患者病理生理机制上的异同。方法:根据结肠转运时间(CTT)和传输指数(TI)对FC患者进行分型,分为传输时间正常型(NTC)、慢传输型(STC)、出口梗阻型(OOC)和混合型(MC);用肛门直肠测压的方法测定不同类型FC患者的肛门直肠动力及感觉功能,同时选择健康人作对照组。结果:与健康对照组相比,FC患者肛管静息压降低,排便感觉阈值和最大耐受容量均增高(P<0.01);各型FC患者肛管静息压均降低(P<0.01);NTC组和OOC组排便感觉阈值和最大耐受容量增高(P<0.01);STC组引起直肠肛门抑制反射的最低容量(MRV)降低,初始感觉阈值降低、排便感觉阈值增高(P<0.05);各组间肛管静息压、缩榨压、排便感觉阈值比较均未见明显异常。结论:肛门直肠动力和感觉功能异常,是FC患者发病的一个重要的病理生理机制。NTC患者和OOC患者在动力和感觉功能上表现出一定的共性,推断其病理生理机制可能存在一定的联系。STC患者的发病是多因素造成的动力紊乱。
OBJECTIVE: To compare the anorectal motility and sensory function of different types of patients with functional constipation (FC), and to compare the similarities and differences in the pathophysiological mechanisms between different types of patients with FC. Methods: FC patients were divided according to CTT and TI, and were divided into NTC, STC, OOC and MC ); Anorectal manometry method was used to determine the anorectal motility and sensory function of different types of FC patients, meanwhile healthy subjects were selected as the control group. Results: Compared with the healthy control group, the resting pressure of anal canal decreased and the defecation threshold and maximum tolerated capacity of FC patients increased (P <0.01). The resting pressure of anal canal decreased in all FC patients (P <0.01) (P <0.01). The minimum volume of rectum anorectal reflex (MRV), the initial threshold of sensation and the threshold of defecation increased in STC group (P <0.05) There was no obvious abnormality in anal canal resting pressure, compression pressure and defecation sensation threshold between groups. Conclusion: Anorectal motility and abnormal sensory function are an important pathophysiological mechanism in the pathogenesis of FC. NTC patients and patients with OOC have certain commonalities in motility and sensory function, and it is concluded that there may be some connection between their pathophysiological mechanisms. The incidence of STC is a multifactorial motility disorder.