权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Investigation of chronological changes in anorectal and somatosensory neural function in pediatric surgical diseases.

小儿外科疾病中肛肠和体感神经功能的时间变化调查。

基本信息

批准号：
10671671
负责人：
KUBOTA Masayuki
金额：
$ 2.11万
依托单位：
Kyushu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10671671/
关键词：
magnetic stimulation external anal sphincter sacral nerve pelvic nerve anorectal malformation Hirschsprung's disease biliary atresia internal anal sphincter

项目摘要

Background :In our previous works in RESEARCH PROJECT, GRANT-IN AID FOR SCIENTIFIC RESEARCH from 1996 to 1998, we have found 1) the anorectal dysfunction in patients with anorectal malformation, Hirschsprung's disease and chronic constipation and 2) somatosensory evoked potential abnormalities in post-operative patients with biliary atresia. In comparison with adult's patients, a chronological improvement has been more frequently found in pediatric patients, which is the most important issue in the assessment of pediatric surgical diseases. So, chronological changes in patients with anorectal malformation and atresia were investigated.Results :1) anorectal malformation :In an analysis of EAS EMG using magnetic spinal nerve stimulation, EMG latency was initially elongated in high-type patients (5.8vs. 3.8 msec, patients vs. controls). Maximum EMG response was obtained in response to lumbar spinal stimulation instead of sacral nerve stimulation, suggesting the congenital dysfunction of p … More udendal nerve innervating EAS. In the long-term follow-up of the these patients up to 5 years revealed that these abnormal findings were gradually improved, associated with improvement of the bowel function. Furthermore, in the study of electrical pudendal nerve stimulation, initial abnormal findings, such as increased threshold to induce a twitch contraction of EAS or failure to induce a twitch contraction, was also chronologically improved. Chronological improvements of the sphincter function may contribute to the improvement of post-operative bowel function in patients with anorectal malformation.2) biliary atresia :Spinal evoked potential at the level of sacral segment was disturbed in long-standing icteric patients even with normal serum level of Vitamin E. In patients who restored a normal liver function after liver transplantation, these evoked potential abnormalities were gradually recovered. Somatosensory evoked potential abnormality in biliary atresia might be caused by the multi-factorial events related to the liver dysfunction.Conclusion :These results suggest that both anorectal and somatosensory dysfunction in pediatric surgical patients were not permanent phenomena as in adults' patients and there is a good possibility of functional improvement after corrective surgical intervention. Less

背景：在1996 ~ 1998年的科研资助项目中，我们发现1）肛门直肠畸形、先天性巨结肠和慢性便秘患者存在肛门直肠功能障碍; 2）胆道闭锁术后患者存在体感诱发电位异常。与成人患者相比，儿童患者的时间改善更常见，这是儿科外科疾病评估中最重要的问题。结果：1）肛门直肠畸形：在磁刺激脊髓神经的EAS肌电图分析中，高型患者的EMG潜伏期最初延长（5.8vs. 3.8 msec，患者与对照）。最大肌电反应是对腰脊刺激而不是骶神经刺激的反应，这表明先天性功能障碍是由神经传导系统引起的。 ...更多信息支配EAS的阴部神经。在这些患者长达5年的长期随访中发现，这些异常结果逐渐改善，与肠道功能的改善有关。此外，在电阴部神经刺激的研究中，最初的异常发现，如增加的阈值，以诱导抽动收缩的EAS或未能诱导抽动收缩，也按时间顺序改善。肛门直肠畸形患者括约肌功能的改善可能有助于术后肠功能的改善。2）胆道闭锁：长期黄疸患者即使血清维生素E水平正常，骶段脊髓诱发电位也会出现紊乱。在肝移植后肝功能恢复正常的患者中，这些诱发电位异常逐渐恢复。胆道闭锁患者的体感诱发电位异常可能是由肝功能异常相关的多因素事件引起的。结论：小儿外科患者的肛门直肠和体感功能障碍并不像成人患者那样是永久性的，经纠正性手术干预后有很好的改善功能的可能性。少