功能性出口梗阻型便秘排便动力学研究

目的　探讨功能性出口梗阻型便秘排便动力学特点 ,为诊断和治疗提供依据。方法　 40例结肠传输功能正常的功能性出口梗阻型便秘 (FOOC)患者行肛肠测压 ,肛管肌电图测定等动力学检查 ,计算出动力参数 ,运动指数 ,并与 2 0例自愿受试者作对照分析。结果　静息状态下内括约肌压力FOOC组高于正常对照组 (P <0 .0 5 ) ;FOOC的直肠感知敏感性降低 ;FOOC组与正常对照组比较肛管超慢波及不规律波增多 ,运动指数升高 ,自发性松弛减少 ;FOOC组 2 5 %肛管外括约肌无排便时的松弛反射 ,5 2 .5 %EMG为矛盾性收缩。结论　FOOC患者存在平滑肌、横纹肌、自主神经或体神经的功能障碍

The study on the evacuation motility of functional outlet obstruction constipation

Objective To assess the evacuation motility of functional outlet obstruction constipation (FOOC) to provide theoretical support for diagnosis and treatment of FOOC. Methods Anorectal manomentry and anal electromyography (EMG) were carried out in 40 FOOC patients with normal colonic transit and 20 healthy controls. Anorectal motility parameters and motility index (MI) were calculated. Results FOOC group had higher internal anal sphincter pressure than control group ( P< 0.05) at rest. Rectal sensation of FOOC group was lower than that of control group. Anal slow wave and irregular wave and MI increased, and spontaneous relax wave decreased in FOOC group compared with controls. There was no anal sphincter inhibitory reflex in 25% patients. In 52.5% patients, EMG appeared contradictory contractile activities.Conclusion The results suggest that the patients with FOOC have dysfunction of the smooth muscle, striatal muscle and autonomic nerves.