【摘要】 目的探讨高龄(>80岁)老年慢性便秘病人肛门直肠动力学的改变。方法选取高龄老年慢性便秘病人35例,同时选取非老年成人病人36例、年龄60~80岁老年病人35例,采用灌注式测压装置对病人进行肛管压力及直肠感觉容量的测定。结果高龄老年慢性便秘组肛管静息压、最大缩榨压明显低于老年及非老年慢性便秘组,差异有统计学意义(F=8.578和9.000,均P<0.01);高龄老年慢性便秘组女性肛管最大缩榨压低于男性,差异有统计学意义(t=2.193,P=0.036);伴有排便不尽感、排便费力的高龄老年慢性便秘病人的肛门括约肌矛盾运动发生率显著高于无伴随症状的高龄老年便秘病人(χ2=4.65和χ2=4.27,均P<0.05)。结论高龄老年便秘病人肛门直肠动力学不同于老年及非老年便秘病人,性别是影响高龄老年便秘病人肛门直肠动力学改变的因素之一。伴有排便困难、排便不尽感的部分高龄老年病人的便秘可能与出口梗阻有关。更多还原

【Abstract】 Objective To investigate the dynamic abnormality of anorectum in the elderly patients aged more than 80 years with chronic constipation.Methods A total of 35 very elderly patients(aged more than 80 years),35 elderly patients(aged 60-80 years) and 36 non-elderly adults with chronic constipation were enrolled.Water-perfused anorectal manometry was used to detect anal pressure and the sensation and tolerance of rectum.Results Anal resting pressure and maximum squeeze pressure(MSP) were significantly lower in the very elderly group than those in elderly group and non-elderly group(F=8.578 and F=9.000,P<0.01).MSP was significantly lower in the female than that in the male in the very elderly group(t=2.193,P=0.036).The incidence of paradoxical motility of anal sphincter in the very elderly patients with incomplete defecation and straining at defecation was significantly higher than that in the patients without above symptoms(χ~2=4.65 and χ~2=4.27,P<0.05).Conclusions Anorectal motility in very elderly patients with constipation is different from that in elderly and non-elderly patients with constipation.Sex is one of the influencing factors of changes of anorectal motility.Constipation in the very elderly patients with imcomplete defecation and straining at defacation may be associated with outlet obstruction.更多还原