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目的 :探讨自体肠平滑肌内括约肌重建术后对低位直肠癌患者肛门功能的影响。方法 :对 2 8例低位直肠癌自体肠平滑肌移植内括约肌重建患者术前、术中及术后 1～ 6个月 ,分别行肛肠测压。结果 :术后肛管静息压明显降低 (P <0 .0 1) ,直肠静息压和重建内括约肌“静息压”无明显改变 (P >0 .0 5 ) ;肛门最大收缩压和最大耐受容积较术前均明显降低 (P <0 .0 1) ,随着时间推移逐渐恢复 ,但不能恢复到术前水平 ;肛门直肠抑制反射无明显恢复 (P >0 .0 5 )。结论 :肛肠测压检查是一种安全、无创的客观检查技术 ,可对术前、术后肛肠功能细微和量化的评价 ,为术后肛肠功能恢复提供客观指标。
Objective: To investigate the effect of autologous intestinal smooth muscle internalization after sphincter reconstruction on anal function in patients with low rectal cancer. Methods: Preoperative, intraoperative and postoperative 1 to 6 months after operation of internal sphincter reconstruction in 28 patients with low rectal carcinoma with autologous intestinal smooth muscle transplantation were performed anorectal manometry. Results: The postoperative anorectal pressure decreased significantly (P <0 01), rectal rest pressure and reconstruction of internal sphincter “resting pressure” had no significant change (P> 0.05); anal maximum systolic pressure and The maximum tolerated volume was significantly lower than that before operation (P <0.01), and gradually recovered with time, but not restored to preoperative level. There was no significant recovery of anorectal inhibitory reflex (P> 0.05). Conclusion: Anorectal manometry is a safe and noninvasive objective examination technique, which can evaluate subtle and quantitative preoperative and postoperative anorectal functions and provide an objective index for postoperative anorectal function recovery.