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老年特发性便秘患者直肠肛门动力学变化及心理评价 被引量:8

CHANGES IN ANORECTAL DYNAMICS AND PSYCHOLOGICAL EVALUATION IN ELDERLY PATIENTS WITH CHRONIC IDIOPATHIC CONSTIPATION
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摘要 探讨老年慢性特发性便秘 (CIC)患者直肠肛门运动功能变化及其与心理因素的关系。采用瑞典Medtronic公司生产的 8通道水灌注式消化道压力检测系统、Zung抑郁自评量表 (SDS)及焦虑自评量表 (SAS)对5 9例患者及 36例老年对照者进行直肠肛门压力测定及心理状况分析。结果发现 ,老年CIC患者最大缩榨压、模拟排便时肛管压力变化低于老年对照组 (P <0 0 5 ) ,直肠初始感觉阈值、排便阈值和最大耐受容量均高于老年对照组 (P <0 0 5 ) ,并有 2 8例 (4 7 5 % )CIC患者模拟排便时出现肛管压力异常升高。老年CIC患者SDS、SAS标准总分均明显高于老年对照组 (P <0 0 5 )。说明老年CIC患者与直肠低敏感、高耐受及排便时直肠肛管运动不协调有关 ,抑郁情绪和焦虑情绪与老年CIC患者肠道运动功能异常有关。 To investigate what anorectal dynamic abnormality and psychological factors exits in elderly patients with chronic idiopathic constipation (CIC), study was performed in 59 elderly patients with CIC and 36 elderly healthy subjects(EHS).Anorectal pressure was measured with Medtronic PcPolygraf,which was a water perfused catheter system.All subjests completed a self-rated inventory assessing psychological distress including depression(SDS) and anxiety(SAS). Maximal squeezing pressure and the changes in anal pressure during defecation in elderly patients(EP) with CIC were lower than those in EHS(P<005)The rectal lowest volume of sensory threshold(RLSTV),the rectal threshold volume for desire to defecate and the rectal maximal volume of tolerance were higher in EP than those in EHS(P<005). There were 28(475%) of EP who had increasing anal pressure when defecation was stimulated.The scores of SDS and SAS were higher in EP than those in EHS(P<005). It suggested that elderly patients with CIC may be associated with lower sensitivity,higher tolerance and discoordination of annorectum during defecation.Both depression and anxiety were associated with abnormal dynamics in EP with CIC.
机构地区 解放军总医院
出处 《解放军医学杂志》 CAS CSCD 北大核心 2001年第4期302-304,共3页 Medical Journal of Chinese People's Liberation Army
关键词 老年人 便秘 测压法 直肠肛门动力学 心理学 elder constipation anorectal manometry psychological factors
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  • 1Dr. Gabrio Bassotti MD, PhD,Giuseppe Chiarioni MD,Italo Vantini MD,Cesare Betti MD,Carla Fusaro MD,Maria Antonietta Pelli MD,Antonio Morelli MD. Anorectal manometric abnormalities and colonic propulsive impairment in patients with severe chronic idiopathic constipation[J] 1994,Digestive Diseases and Sciences(7):1558~1564
  • 2Dr. Gabrio Bassotti MD,Giuseppe Chiarioni MD,Bruno Pietro Imbimbo PharmD,Cesare Betti MD,Fabrizio Bonfante MD,Italo Vantini MD,Antonio Morelli MD,William E. Whitehead PhD. Impaired colonic motor response to cholinergic stimulation in patients with severe chronic idiopathic (slow transit type) constipation[J] 1993,Digestive Diseases and Sciences(6):1040~1045
  • 3Stanislas Chaussade,Abdallah Khyari,Hervé Roche,Marc Garret,Marianne Gaudric,Daniel Couturier,Jean Guerre. Determination of total and segmental colonic transit time in constipated patients[J] 1989,Digestive Diseases and Sciences(8):1168~1172

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