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頁籤選單縮合
題名 | Anal Manometric Findings before and after Hemorrhoidectomy: A Preliminary Report=痔瘡術前與術後肛門動力學檢查之發現:初步報告 |
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作者 | 陳漢祥; | 書刊名 | 長庚醫學 |
卷期 | 22:1 1999.03[民88.03] |
頁次 | 頁25-30 |
分類號 | 416.245 |
關鍵詞 | 動力學檢查; 休息時壓力; 直腸代償作用; 收縮時壓力; Manometry; Mean resting pressure; Rectal compliance; Mean squeeze pressure; |
語文 | 英文(English) |
中文摘要 | 背景:有痔瘡症狀之病人接受痔瘡手術前後與無痔瘡症狀之正常人,肛門生理是 否有變化,仍然有不同意見。 方法:24位具有痔瘡症狀之病人,接受直腸肛門動力學檢查。共有12位男性和12位女性,平 均年齡 42 歲(範圍:23 至 72 歲)。動力學檢查是在手術前一天和手術後 8 到 12 星期 做。這些數據與類似年齡和同樣性別之 138 個無痔瘡症狀之正常人來作比較。 結果:在術前、術後與正常人之情形下,直腸肛門反射均有呈現,臨床上無肛門失禁之情 形。 在有症狀之痔瘡患者其肛門平均休息時壓力(平均值:84.5 ± 28.7 公分水柱,範圍 :26 至 166 公分水柱)較正常人(平均值: 74.4 ± 14.9 公分水柱, 範圍:61 至 116 公分水柱)及痔瘡手術後(平均值:63.7 ± 23.6 公分水柱, 範圍:20 至 116 公分水柱 )高,並達統計學之意義( p = 0.032 & 0.005 )。 而術後其肛門平均休息時壓力較正 常人低,亦達統計學之意義( p = 0.018 )。其它直腸肛門動力學檢查數據,在手術前、 後與正常人並沒有統計學之差異。 結論:有痔瘡症狀之病人,比無痔瘡症狀之正常人有較高之肛門休息時壓力。內括約肌活動 過強,可能是有痔瘡症狀的原因。痔瘡手術後,肛門休息時壓力會較有痔瘡症狀和無痔瘡症 狀之正常人低,這可預防痔瘡之復發。直腸代償作用和收縮時壓力之增加則可預防肛門失禁 。 |
英文摘要 | Background: A difference of opinion exists as to whether patients with symptomatic hemorrhoids, patients after hemorrhoidectomy, and patients with no hemorrhoids have different anal physiologies. Methods: Twenty-four patients with symptomatic hemorrhoids undergoing hemorrhoidectomy were investigated using anorectal manometry. There were 12 male and 12 female patients with a mean age of 42 years (range: 23 to 72 years). The anorectal manometry was performed one day before the operation and 8 to 12 weeks after the operation. Another normal group, comprised of 138 volunteers, was included and matched for age and gender. Results: The anorectal inhibitory reflex was present in all the normal group (NG), symptomatic hemorrhoid (SH), and post-hemorrhoidectomy (PH) patients. No major incontinence was noted clinically. The mean resting pressure (MRP) in the SH group (mean: 84.5 ± 28.7 cmH �� O, range: 26 to 166 cmH �� O) was significantly greater than in the NG (mean: 74.4 ± 14.9 cmH �� O, range: 61 to 116 cmH �� O) and the PH groups (mean: 63.7 ± 23.6 cmH �� O, range: 20 to 116 cmH �� O) (p=0.032 and 0.005, respectively). After hemorrhoidectomy, the MRP was significantly decreased compared to the normal group (p=0.018). The other manometric data showed no statistical change in these three groups. Conclusion: The results indicate that persons with SH have a higher MRP than normal. Overactivity of the internal sphincter muscle may be a cause rather than a result of symptomatic hemorrhoids. Compared with the SH and normal groups, the MRP was significantly decreased to prevent recurrent symptomatic hemorrhoids in the PH group. Though the MRP was significantly decreased, no major incontinence was noted after hemorrhoidectomy, and this might be due to the increase in rectal compliance and mean squeeze pressure. |
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