摘要
目的探讨老年慢性便秘患者肛门直肠动力学的改变。方法采用灌注式测压装置测定58例老年慢性便秘患者和36例非老年成人慢性便秘患者的肛管压力及直肠感觉容量的变化，并对结果进行比较。结果老年慢性便秘组肛管静息压（59．74±2．31）mmHg（1mmHg=0．133kPa），明显低于非老年慢性便秘组（68．22±2．37）mmHg，差异有统计学意义（t=2．430，P=0．017）。伴有排便不尽感、大便Bristol分型3～5型、排便费力的老年慢性便秘患者的肛门括约肌矛盾运动发生率显著高于无症状者（χ^2=8．880、11．540、6．070，P=0．003、0．001、0．014）；伴有排便费力、腹痛的老年慢性便秘患者最大耐受容量低于对照组，差异有统计学意义（t=2．140、2．260，P=0．036、0．032）。不同性别的老年慢性便秘患者的肛门直肠动力学差异均无统计学意义。结论老年慢性便秘患者肛门直肠动力学不同于非老年便秘患者，伴有不同症状的老年慢性便秘患者具有不同的肛门直肠动力学特点。
Objective To investigate the dynamic abnormality of anorectum in elderly patients with chronic constipation. Methods Anorectal perfusion manometry was performed to detect the change of anal canal pressure and the rectal sensation capacity in 58 elderly patients and 36 non-elderly adults with chronic constipation. The results were compared retrospectively. Results Anal resting pressure in a chronic constipation was significantly lower in elderly patients than in non-elderly adults, with statistically significant difference [ （ 59.74± 2.31 ） mmHg vs. （ 68.22 ± 2.37 ） mmHg, t = 2.430, P =0. 0173. The incidence of paradoxical motility of anal sphincter was significantly higher in elderly patients with three abnormalities（incomplete defecation, Bristol stool scale type 3-5 and straining at defecation） than in elderly patients without above three abnormalities （χ^2 = 8. 880,11. 540,6. 070, P = 0. 003,0. 001,0. 014）. Maximal tolerable volume was significant lower in elderly patients with straining at defecation and abdominal pain than in control group （t = 2. 140, 2. 260, both P 〈 0.05）. No correlation was observed between sex and anorectal motility in elderly patients with chronic constipation. Conchtsions Anorectal motility in elderly patients with chronic constipation is different from that in non-elderly patients with chronic constipation. The dynamic abnormalities of anorectum in chronic constipation are different in elderly patients with different symptoms.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2017年第9期979-982,共4页
Chinese Journal of Geriatrics
关键词
便秘
肛管
测压法
Constipation
Anal canal
Manometry
