论文部分内容阅读
目的探讨功能性便秘(FC)患儿治疗前后肛门直肠动力学及结肠传输试验的改变。方法选取2008年1月-2009年12月在唐都医院儿科就诊的FC患儿35例为FC组,选取同期无消化系统症状,排便正常的健康儿童10例为健康对照组。采用不透光X线标记物(ROM)测定其结肠传输指数(TI),将FC患儿分为慢传输型便秘(STC)和出口梗阻型便秘(OOC)。采用荷兰MMS公司的SolarGI胃肠动力学检查系统,测定肛门直肠动力学指标,FC组服用聚乙二醇4000散剂,观察其疗效,检测治疗前后肛门直肠动力学改变。结果 FC组与健康对照组及2种类型FC组间肛门括约肌静息压比较差异均无统计学意义(Pa>0.05)。OOC组肛门括约肌最大收缩压较健康对照组及STC组高,差异均有统计学意义(Pa<0.05)。FC组直肠最低敏感量及最大耐受量均较健康对照组高,差异均有统计学意义(Pa<0.05)。治疗后STC组、OOC组肛门括约肌静息压及肛门括约肌最大收缩压与治疗前比较差异均无统计学意义(Pa>0.05)。治疗后STC组、OOC组与治疗前比较直肠最低敏感量及直肠最大耐受量明显下降,差异均有统计学意义(Pa<0.05)。FC组治疗后与健康对照组肛门括约肌静息压、肛门括约肌最大收缩压,直肠最大耐受量比较差异均无统计学意义(Pa>0.05)。治疗后OOC组与健康对照组直肠最低敏感量比较差异仍有统计学意义(P<0.05)。结论 FC患儿存在明显的肛门直肠动力学、感觉异常及结肠传输功能障碍,聚乙二醇4000治疗可改善此类异常。
Objective To investigate the changes of anorectal motility and colonic transit test in children with functional constipation (FC) before and after treatment. Methods From January 2008 to December 2009, 35 children with FC in pediatric department of Tangdu Hospital were selected as FC group. Ten healthy children without normal digestive symptoms and normal defecation were selected as healthy control group. The colonic transit index (TI) was measured by opaque X-ray markers (ROM), and the children with FC were divided into slow transit constipation (STC) and outlet obstruction constipation (OOC). The DutchGMGG SolarGI gastrointestinal motility test system was used to determine anorectal kinetic parameters. The FC group was given polyethylene glycol 4000 powder to observe its curative effect. The anorectal dynamic changes before and after treatment were measured. Results The resting pressure of anal sphincter between FC group and healthy control group and two kinds of FC group showed no significant difference (Pa> 0.05). The maximum systolic pressure of anal sphincter in OOC group was significantly higher than that in healthy control group and STC group (P <0.05). The lowest rectal sensitivity and maximal tolerability of rectal in FC group were higher than those in healthy control group (all P <0.05). After treatment, STC group, OOC group anal sphincter resting pressure and anal sphincter systolic blood pressure and before treatment were no significant difference (Pa> 0.05). After treatment, the lowest rectal sensitivity and the maximal rectal tolerance of STC group and OOC group were significantly lower than those before treatment, the difference was statistically significant (Pa <0.05). There were no significant differences in resting pressure of anal sphincter, maximal systolic pressure of anal sphincter and maximal tolerability of rectum between FC group and healthy control group (Pa> 0.05). After treatment, OOC group and healthy control group the lowest rectal sensitivity was still statistically significant (P <0.05). Conclusions FC patients have significant anorectal motility, sensory abnormalities and colonic transit dysfunction. Treatment with polyethylene glycol 4000 may improve this abnormality.