Fecobionics assessment of the effect of position on defecatory efficacy in normal subjects
Fecobionics assessment of the effect of position on defecatory efficacy in normal subjects
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DOI：
10.1007/s10151-021-02439-2
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发表时间：
2021-03-29
影响因子：
3.3
通讯作者：
Gregersen, H.
中科院分区：
文献类型：
--
作者：
Chen, S. -C.;Futaba, K.;Gregersen, H.
背景排便是一个复杂的过程，多达25%的人患有排便功能障碍的症状。对于肛门直肠疾病的功能测试、诊断和治疗，了解最佳排便位置是很重要的。本研究的目的是使用一种名为Fecobion的模拟粪便装置来评估正常人侧卧、坐位和蹲位的排便压力模式。方法于2019年5月29日至12月9日进行了一项干预性研究设计，评估了排便参数。受试者通过香港中文大学的广告被邀请参与这项研究。生物仿生学装置由一个前部(尾端)和后部(头端)装有压力传感器的核心和一个覆盖大部分核心长度的聚酯氨酯袋子组成，该核心长度也包含传感器。正常受试者(既往无排便障碍症状、无腹部手术、无药物或慢性疾病)的直肠中的仿生袋膨胀至50毫升。研究是在侧卧(左侧卧位)、坐位(髋关节屈曲90度)和蹲姿(髋关节屈曲25度)下进行的。结果12例患者，女性6例，男性6例，平均年龄26.3+/-2.6岁[19.0~48.0]岁，均按计划完成手术。侧卧和坐位的肛门静息压分别为33.1+/-4.1cmH(2)O和37.1+/-4.0cmH(2)O(p>；0.3)。侧卧位和坐位的肛门挤压压分别为98.4+/-6.9cmH(2)O和142.3+/-16.4cmH(2)O(p<；0.05)。侧卧位、坐位和蹲位的驱逐时间分别为108.9±8.3%S、15.0±-2.1%S和16.1%+/-2.9%S(P<0.01)。坐式和蹲式的最大排气压力分别为130.1+/-12.4cmH(2)O和134.0+/-11.1cmH(2)O(p>；0.5)。前后位压力图和膨胀性指数显示侧卧位置组与其他位置组的压力模式有明显差异。结论卧位时排出仿生装置的延迟与装置上的压力模式不协调有关。坐姿和蹲姿之间没有发现数量上的差异。试用注册标识：NCT03317938。
Background Defecation is a complex process and up to 25% of the population suffer from symptoms of defecatory dysfunction. For functional testing, diagnostics, and therapy of anorectal disorders, it is important to know the optimal defecation position. is The aim of this study was to evaluate defecation pressure patterns in side lying, seated and squatting defecation positions in normal subjects using a simulated stool device called Fecobionics.Methods The Fecobionics expulsion parameters were assessed in an interventional study design conducted from May 29 to December 9 2019. Subjects were invited to participate in the study through advertisement at The Chinese University of Hong Kong. The Fecobionics device consisted of a core containing pressure sensors at the front (caudal end) and rear (cranial end) and a polyester-urethane bag spanning most of the core length which also contained sensors. The Fecobionics bag was distended to 50 ml in the rectum of normal subjects (no present and past symptoms of defecatory disorders, no prior abdominal surgery, medication or chronic diseases). Studies were done in side lying (left lateral recumbent position), seated (hip flexed 90 degrees) and squatting position (hip flexed 25 degrees). Pressure endpoints including the rear-front pressure diagram and defecation indices were compared between positions.Results Twelve subjects (6 females/6 males, mean age 26.3 +/- 2.6 [19.0-48.0] years) were included and underwent the planned procedures. The resting anal pressure for side lying and seated positions were 33.1 +/- 4.1 cmH(2)O and 37.1 +/- 4.0 cmH(2)O (p > 0.3). The anal squeeze pressure for side lying and seated positions were 98.4 +/- 6.9 cmH(2)O and 142.3 +/- 16.4 cmH(2)O (p < 0.05). The expulsion duration for the side lying, seated and squatting positions were 108.9 +/- 8.3 s, 15.0 +/- 2.1 s and 16.1 +/- 2.9 s, respectively (p < 0.01 between lying and the two other positions). The maximum evacuation pressure for seated and squatting were 130.1 +/- 12.4 cmH(2)O and 134.0 +/- 11.1 cmH(2)O (p > 0.5). Rear-front pressure diagrams and distensibility indices demonstrated distinct differences in pressure patterns between the side lying position group and the other positions.Conclusions The delay in expelling the Fecobionics device in the lying position was associated with dyssynergic pressure patterns on the device. Quantitative differences were not found between the seated and squatting position. Trial Registration Identifier: NCT03317938.