摘要
目的分析肠神经发育不良(IND)患儿直肠肛门测压有关参数,探讨其与IND病理改变程度的关系及直肠肛门测压在IND诊断中的作用。方法对20例重型肠神经发育不良(SIND)和41例轻型肠神经发育不良(MIND)患儿及20例功能性便秘(FC)患儿同时作直肠肛门测压检查。结果SIND患儿平均发病年龄明显低于MIND及FC患儿;SIND患儿直肠肛门抑制反射(RAIR)发生率明显低于MIND及FC患儿;与MIND及FC患儿比较,SIND患儿直肠静止压、肛管静止压、肛管高压带长度及直肠顺应性之间无明显差异;但平均反射阈值、平均反射潜伏期及平均反射持续时间之间却有显著差异。IND直肠肛门测压并无特征性改变,RAIR表现为不典型松弛波,呈“W”或“V”形,其反射阈值增大,反射潜伏期及反射持续时间长,RAIR与IND病理改变程度呈相关性变化。结论结合钡灌和乙酰胆碱酯酶组织化学检查,直肠肛门测压可协助诊断IND,并可作为反应IND病理类型的一项参考指标。
Objective To analyze the parameters of anorectal manometry of children with intestinal neuro dysplasia（IND） and explore whether it correlates with the severity of histopathologic findings and its significance for diagnosing IND. Methods Twenty severe IND（SIND）children and 41 mild IND（MIND） children were inspected by means of anorectal manometry, and the findings were compared with 20 children with functional constipation（FC）. Results Children with SIND manifested their symptom at an earlier age than these with MIND and FC group. Rectal and anal sphincter reflexes（RAIR） were absent frequently in SIND group compared with MIND group and FC group. Rectal resting pressure, anal canal resting pressure, rectal compliance and the length of anal high pressure were not various different in SIND, MIND and FC group. Average reflex threshold volume, average reflex latency and average reflex duration were markedly different in SIND, MIND and FC group. The alteration of anorectal manometry of IND is not characterized, but RAIR in IND is atypical .whose wave is “W” or “V” shape; its reflex threshold volume is enlarged：its reflex latency and reflex duration are longer. Its RAIR presentation correlates with the ,severity of its histochemical findings. Conclusions With banium enema and ache histochemistry examination, anorectal manometrymay help diagnose IND, and is regarded as a reference marker to evaluate its pathology type.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2005年第8期809-811,共3页
Journal of Applied Clinical Pediatrics
关键词
肠神经发育不良
直肠肛门测压
直肠肛门抑制反射
儿童
intestinal neurodysplasia
anorectal manometry
rectal and anal sphincter reflexes
children
