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目的 研究直肠肛门瘘手术前后肛肠动力学的变化。方法 对37 例肛瘘患者手术前后用直肠肛管测压法检测直肠肛门反射(RAR) 、肛管最大收缩压(AMCP) 、肛管最长收缩时间(ALCT)、直肠静息压(RRP)、肛管静息压(ARP)5 项技术指标。对肛瘘手术前后及其低位、高位手术前后、低位与高位术后进行比较,并与30名正常人进行对比。结果 术后RAR 完全恢复并敏感率提高( P< 0-01) ,与正常人无差异( P> 0-05) ;AMCP与术前无差异( P> 0-05) ,比正常人明显降低( P< 0-01) ;ALCT 与术前无差异( P> 0-05) ,比正常人延长( P< 0-05) ;RRP术后降低( P<0-01),与正常人无差异( P> 0-05) ;ARP术后降低( P< 0-01),比正常人亦显著降低( P< 0-01)。结论 肛瘘疾病及肛管内外括约肌损伤的严重程度对肛门的闭紧功能产生直接影响,尤其是高位肛瘘可能引起部分患者的气体或液体失禁。
Objective To study the dynamic changes of anorectal anorectal anorectal fistula before and after surgery. Methods Rectal anal canal manometry (RAR), anal maximum systolic pressure (AMCP), anal canal longest contraction time (ALCT), rectal resting pressure (RRP) were performed in 37 patients with anal fistula before and after operation. Anal resting pressure (ARP) 5 technical indicators. Before and after the operation of anal fistula and its low, high before and after surgery, low and high postoperative comparison, and with 30 normal subjects were compared. Results The postoperative RAR was completely recovered and the sensitivity was increased (P <0-01), no difference with normal people (P> 0-05). There was no difference between AMCP and preoperative (P> 0-05) (P <0-01). There was no difference between ALCT and preoperative (P> 0-05), prolongation (P <0-05) (P> 0-05). The levels of ARP decreased (P <0-01) and also significantly lower than those in normal subjects (P <0-01). Conclusion The severity of anal fistula and the anal sphincter injury have a direct impact on the anorectal tightness. In particular, the high anal fistula may cause gas or liquid incontinence in some patients.