Motility and tone of the left colon in constipation: a role in clinical practice?
Motility and tone of the left colon in constipation: a role in clinical practice?
复制标题
便秘时左结肠的蠕动和张力：在临床实践中的作用？
DOI：
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发表时间：
1996
影响因子：
9.8
通讯作者：
R. Hanson
中科院分区：
文献类型：
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作者：
Michael D. O'Brien;M. Camilleri;M. R. Ohe;M. R. Ohe;Sidney F. Phillips;J. H. Pemberton;C. Prather;J. Wiste;R. Hanson
目标
结肠动力机制在便秘中的错乱还没有完全了解。我们的目的是测量慢性便秘患者空腹和餐后左结肠动力和声调。
方法
测定15例健康对照组和40例慢性便秘患者空腹和餐后2小时左半结肠压力(多腔测压)和压力(稳压)，其中慢性便秘合并结肠传输缓慢(n=15)、正常(n=12)和出口梗阻(n=13)。
结果
所有组的空腹语调都是相似的，并且都显示出对食物的运动活动显著增加。慢传输组和出口梗阻组的餐后音调降低(p<；0.05)。在紧张性反应的时间或高压传播的收缩的数量或幅度方面没有差异。慢传输组直肠乙状结肠(p<；0.05)和降结肠(p<；0.1)餐后相反应较低，出口梗阻组下降(p<；0.05)和直肠乙状结肠(p<；0.1)相反应较小。
结论
单独的结肠腔内测量不能比运输和盆底试验更准确地区分慢性便秘的亚组，目前在临床实践中的作用有限。然而，测压和声调测量可能有助于确认慢传输型便秘(结肠惰性)的诊断，这些患者被认为是手术治疗的候选对象。
OBJECTIVES
Colonic motor mechanisms deranged in constipation are not understood completely. Our aim was to measure left colonic motility and tone, during fasting and postprandially in patients with chronic constipation.
METHODS
During 1 h fasting and 2 h postprandially, we measured pressures (multilumen manometry) and tone (barostat) in the left colon of 15 healthy controls and 40 patients with chronic constipation associated with slow (n = 15) or normal colonic transit (n = 12) or outlet obstruction (n = 13).
RESULTS
Fasting tone was similar in all groups, and all demonstrated a significant increase in motor activity to food. There was lower postprandial tone (p < 0.05) in the slow transit and outlet obstruction groups. There were no differences in the timing of the tonic response or the number or amplitude of high-pressure propagated contractions. The slow transit group had lower postprandial phasic responses in the rectosigmoid (p < 0.05) and descending (p < 0.1) colon; the outlet obstruction group had lesser descending (p < 0.05) and rectosigmoid (p < 0.1) colon phasic motility.
CONCLUSIONS
Colonic intraluminal measurements alone do not discriminate subgroups of chronic constipation more accurately than transit and pelvic floor tests, and currently have a limited role in clinical practice. However, manometry and tone measurements may be helpful in confirming a diagnosis of slow transit constipation (colonic inertia) in patients considered candidates for surgical treatment.