Anorectal manometric examination in encopretic-constipated children.
Anorectal manometric examination in encopretic-constipated children.
复制标题
大便便秘儿童的肛门直肠测压检查。
DOI：
10.1007/bf02050928
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发表时间：
1997
影响因子：
3.9
通讯作者：
Kovatchev,B
中科院分区：
文献类型：
--
作者：
Sutphen,J;Borowitz,S;Ling,W;Cox,DJ;Kovatchev,B
目得：我们研究了使用肛门直肠测压来区分便秘型便秘儿童（n=88）与同胞对照组（n=16）和非同胞对照组（n=11）。方法：研究变量包括测压法测定的静息和最大自主肛门括约肌压力、直肠肛门抑制反射的深度和速度、最小直肠容积感觉、排便急迫性的临界扩张量、尝试排便时的直肠和肛门压力反应以及在充满水的气囊中排便的能力。研究结果：尝试排便时肛门括约肌压力的变化（P=0.03）、尝试排便时直肠压力和括约肌压力之间的梯度（P=0.02）、大便急迫性的临界扩张量（P=0.02）和使用充水气囊排便的能力（P=0.05）可将便秘型便秘儿童与对照组儿童区分开来。与直肠肛门抑制反射相关的直肠压力的变化在P=0.07时没有显著性。结论：肛门括约肌痉挛和巨结肠是与小儿便秘-大便失禁相关的病理生理异常。
PURPOSE: We have investigated the use of anorectal manometry to distinguish encopretic-constipated children (n=88) from sibling controls (n=16) and nonsibling controls (n=11). METHODS: Study variables included manometrically determined resting and maximum voluntary anal sphincter pressure, depth and speed of rectoanal inhibitory reflex, minimum rectal volume sensation, critical distending volume for fecal urgency, rectal and anal pressure responses during attempted defecation, and ability to defecate a water-filled balloon. RESULTS: Change in anal sphincter pressure during attempted defecation (P=0.03), gradient between rectal and sphincter pressure during attempted defecation (P=0.02), critical distending volume for fecal urgency (P=0.02), and ability to defecate a water-filled balloon (P=0.05) distinguished encopretic-constipated from control children. The change in rectal pressure associated with the rectoanal inhibitory reflex just escaped significance at P=0.07. CONCLUSIONS: Anal sphincter spasm and megacolon are pathophysiologic abnormalities associated with pediatric constipation-encopresis.