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Establishment of the method to explore neural interaction between the sacrum and anorectum using a repetitive magnetic stimulation in children

儿童重复磁刺激探索骶骨与肛门直肠神经相互作用方法的建立

基本信息

批准号：
14370566
负责人：
KUBOTA Masayuki
金额：
$ 8.96万
依托单位：
Niigata University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2005
项目状态：
已结题

项目摘要

The intestinal activity is well known to be secondarily controlled by the central nervous, system through the sympathetic and parasympathetic systems. In the pelvic region, the sacral nervous system influences the bladder and rectoanal function. However, the sacro-anorectal neural interactions in these diseases remain unclear due to the absence of a proper examination modality. We therefore examined the usefulness of sacral magnetic stimulation as a new modality for examining sacro-anorectal interaction.Patients and Methods : Control data was obtained from 25 children without bowel dysmotility. 45 patients with chronic constipation (age range ; 1 m/o to 11 y/o), 8 pre-operative patients with Hirschsprung's disease (1 m/o to 6 y/o) and one female patient with MMIHS (1 y/o) were examined. Magnetic stimulation with a duration of one second delivered at 10 to 15Hz was applied at the S3 level using MagPro(Medtronic) with a figure eight coil while simultaneously performing the manometric rec … More ordings of the anorectal activity.Results : In the 45 patients with chronic constipation and one patient with MMIHS, the rectoanal reflex was demonstrated by balloon rectal dilatation in all patients. Control patients uniformly exhibited a biphasic response consisting of the initial contraction followed by a relaxation. On the other hand, the sphincter response to magnetic stimulation varied among the patients with chronic constipation including no response in 5 patients, a biphasic response of an initial rise followed by a decrease in the sphincter pressure in 36 patients and only a transient rise in pressure in two patient. The MMIHS patient exhibited a transient rise in the sphincter to magnetic stimulation. In eight pre-operative patients with Hirschsprung's disease, no rectoanal reflex was observed, however, the sphincter pressure increased due to magnetic stimulation in five patients, while three patients exhibited no recordable responses.Conclusion : These results suggest that the repetitive magnetic stimulation technique is a valuable modality for elucidating the neural interaction between the sacral nervous system and the anorectum, thereby suggesting its usefulness for obtaining a better understanding of the anorectal pathology. Less

众所周知，肠道活动是由中枢神经系统通过交感神经和副交感神经系统次级控制的。在骨盆区，骶神经系统影响膀胱和直肠肛门功能。然而，骶肛门直肠神经在这些疾病的相互作用仍然不清楚，由于缺乏适当的检查方式。因此，我们研究骶骨磁刺激作为一种新的方式检查骶肛门interaction.Patients和方法：对照数据从25名儿童没有肠动力障碍。对45例慢性便秘患者（年龄范围：1 m/o至11 y/o）、8例先天性巨结肠术前患者（1 m/o至6 y/o）和1例MMIHS女性患者（1 y/o）进行了检查。使用MagPro（Medtronic）和8字形线圈在S3水平施加持续时间为1秒的10 - 15 Hz磁刺激，同时进行测压记录。 ...更多信息结果：45例慢性便秘患者和1例MMIHS患者经球囊直肠扩张均显示直肠肛门反射。对照组患者一致表现出由初始收缩随后松弛组成的双相反应。另一方面，慢性便秘患者对磁刺激的括约肌反应不同，包括5例患者无反应，36例患者的括约肌压力最初升高随后降低的双相反应，2例患者的压力仅短暂升高。MMIHS患者在磁刺激下括约肌出现一过性升高。在8例先天性巨结肠症术前患者中，未观察到直肠肛门反射，然而，5例患者的括约肌压力因磁刺激而增加，而3例患者未表现出可记录的反应。这些结果表明，重复磁刺激技术是一种有价值的方式来阐明骶神经系统和肛门直肠之间的神经相互作用，从而表明其对于更好地理解肛门直肠病理学的有用性。少