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耻骨直肠肌反常收缩(PPC)是引起便秘的主要原因之一。虽然有耻骨直肠肌切断术和肉毒梭状芽胞杆菌A型神经毒素治疗等治疗方法,但作者认为生物反馈治疗是首选方法。作者对便秘病人进行了病史收集、体格检查,并着重进行了实验室检查,包括全结肠运输试验、肛管直肠测压、排粪造影和肛管括约肌肌电图检查。在下列3种检查中,至少有2种异常,才能诊断为PPC。(1)结肠运输试验中,直到第5天,仍至少有20%的结肠标志物滞留在结肠中;(2)排粪造影检查时,不能迅速排出200ml(500g)的钡剂,并且在排便前和排便中拍摄的X线片上,肛管直肠角无明显增加;(3)肌电图检查时,神经肌肉(耻骨直肠肌)的反常活动增加。按此标准,共诊断出18例PPC(女13,男5);平均年龄66.7岁(10～84岁),并已应用泻剂或灌肠26.9年(0.25～74年)。所有病人平均接受8.9次(2～19次)生物反馈治疗,使用的仪器是PerryMeter牌EPS-21型直肠传感器,并将其连于Orion 8600生物反馈电子计算机
Anomalous puborectalis contraction (PPC) is one of the major causes of constipation. Although there are treatments for puborectalis and intramuscular Clostridium botulinum type A neurotoxin, biofeedback therapy is the preferred method. The author of the history of constipation patients were collected, physical examination, and focused on laboratory tests, including the whole colon transport test, anal canal manometry, defecography and anal sphincter EMG examination. In the following three kinds of tests, at least two abnormalities, can be diagnosed as PPC. (1) In colon transport trials, at least 20% of colon markers remain in the colon until day 5; (2) 200 ml (500 g) of barium can not be excreted rapidly during defecography, The anorectal angle of the anorectal tube was not significantly increased on the X-ray film taken before and during defecation; (3) abnormal activity of the neuromuscular (puborectalis) muscle increased during EMG examination. According to this standard, a total of 18 cases of PPC (female 13, male 5) were diagnosed; the average age was 66.7 years old (10-84 years old), and laxative or enema was used for 26.9 years (0.25-25 years). All patients received on average 8.9 (2-19) biofeedback sessions using the PerryMeter EPS-21 Rectal Sensor and attached to the Orion 8600 Biofeedback Computer