不同水温灌肠与肛肠动力学改变的相关性研究

【作者】 杜娟；

【导师】 杨向东；

【作者基本信息】 成都中医药大学 ， 中医外科学， 2013， 硕士

【摘要】 目的：本课题是为了通过研究不同水温灌肠与肛肠动力学改变的相关性,使不同水温灌肠对肛门直肠运动功能的影响不仅有理论意义,而且也有助于温水灌肠治疗肛肠类疾病临床应用的发展和完善。方法：将从2012年6月-2013年3月所招募的健康志愿者120例作为研究对象,按报名的先后编号,随机分为三组,每组40人,即水温(36℃-39℃)组,(39.5℃-42.5℃)组,(43℃-46℃)组,进行不保留灌肠。先期观察受试者对温水灌肠液灌肠的阈值感觉、持续便意、最大耐受容量、便血、灌肠液通畅、粘膜损伤等之间的差异性。半小时后,即行肛门直肠测压检测。检测进行不同水温液灌肠后的初始感觉、初始便意、最大耐受容量、直肠静息压、肛管静息压、肛管最大收缩压等之间的差异。结果：三组研究对象均未发生明显不良反应,三组研究对象的阈值感觉、持续便意、最大耐受容量的比较存在统计学意义(P<0.05)；保留时间、灌肠液外溢、心悸、腹痛、排便感强烈,三组之间有统计学意义(P<0.05);便血、灌肠液通畅、粘膜损伤,三组之间无统计学意义(P>0.05)；三组研究对象在进行直肠动力检测中初始感觉、初始便意、最大耐受容量上的差异有统计学意义(p<0.05)；直肠静息压、肛管静息压、最大收缩压差异没有统计学意义(p>0.05)。且灌肠水温为43℃-46℃时,.肛肠动力学改变明显大于其他两组。结论：.三个水温组灌肠对肛管直肠动力学均有改变,但43℃-46℃的温水灌肠对肛肠动力学改变是较明显的,其中直肠粘膜神经丛的感觉阈值(初始感觉阈值、持续便意、最大耐受容量等)降低较明显,但内括约肌和外括约张力在动力学方面并没有显著性变化。更多还原

【Abstract】 Objective:The purpose of this research is to observe the correlation between different-tempreituer water enema and the change of anorectal dynamics, make the study of different water temperature effect of enema on anorectal motility has not only theoretical significance, but also the development of clinical application anf perfect help warm water enema in the treatment of anorectal diseases.Methods:A randomized study was made in120normal people who volunteered to participate in this study from June of2012to February of2013as the cases.Make the volunteers according to the entry sequence number,then divided into three groups randomly,each group of40people, that is tenperature(36℃-39℃)group,(39.5℃-42.5℃) group,(43℃-46℃) group,do enema not retain.Preliminary observe the subjects of the warm water enema liquid threshold feeling,continuous meaning,the maximum tolerable volume,blood in the stood,enema liquid patency,mucosal injury,and compare the differences between them.Then do the anorectal manomertry detection half an hour later.detected the differences between the rectal resting pressure, anal resting pressure, maximum squeeze pressure,first sensation volume, first defecation volume,maximal tolerable rectal volum after different initial water enema.Results:The three group of subject had no obvious adverse reactions.Comparison of this three groups,the subject threshold,meaning,feeling for maximum tolerance capacity have statistical significance (P<0.05).However,the retention time,enema spillover,palpitations,abdominal pain,defecate feeling strong not have statistical significance (P>0.05).And the comparison of blood in the stood,enema liquid patency,mucosal injury have no statistical significance (P>0.05).Comparison in rectal dynamic detection, the difference between the rectal resting pressure, anal resting pressure and maximum squeeze pressure not have statistical significance (P>0.05),but, the difference between first sensation volume, first defecation volume,maximal tolerable rectal volum have statistical significance (P<0.05).When the water’s tempreture is in the range43℃-46℃,the chang on the anorectal dynamics is obvious more than the other two groups.Conclusion:The change of three temprictuer water enema on anorectal dynamics was obvious.and enema after temperature in the range43℃-46℃water, the change of anorectal dynamics is obvious;among them, plexus rectal sensory threshold of the lower (initial perception threshold and sustained it is intended, the greatest tolerance capacity, anorectal reflex threshold,etc.);but, the tension of inside and outside the sphincter in t e dynamics did not change significantly.更多还原