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首页> 外文期刊>American Journal of Physiology >Comparison of rectoanal axial forces in health and functional defecatory disorders.
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Comparison of rectoanal axial forces in health and functional defecatory disorders.

机译：健康和功能性排便障碍中直肠轴向力的比较。

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摘要

Anal manometry measures circumferential pressures but not axial forces that are responsible for defecation and contribute to fecal continence. Our aims were to investigate these mechanisms by measuring axial rectoanal forces with an intrarectal sphere or a latex balloon fixed at 8, 6, or 4 cm from the anal verge and connected to axial force and displacement transducers. Rectoanal forces and rectal pressures within a latex balloon were measured at baseline (i.e., at rest) and during maneuvers (i.e., squeeze, simulated evacuation, and a Valsalva maneuver) in 12 asymptomatic women and 12 women with symptoms of difficult defecation. Anal resting and squeeze pressures were also assessed by manometry and were similar in control patients and experimental patients. At rest, axial rectoanal forces were directed inward and increased as the device approached the anal verge. Control patients augmented this inward force when they squeezed and exerted an outward force during simulated expulsion and a Valsalva maneuver. The force change during maneuvers was also affected by device location and was highest at 4 cm from the verge. In experimental patients, the force at rest and the change in force during all maneuvers was lower than in control patients. The rectal pressure during a Valsalva maneuver was also lower in experimental patients than in control patients, suggestive of impaired propulsion. In conclusion, a subset of women with defecatory symptoms had weaker axial forces not only during expulsion but also during a Valsalva maneuver and when they squeezed (i.e., contracted) their pelvic floor muscles, suggestive of generalized pelvic floor weakness.
机译：肛门测压法只能测量周向压力，而不能测量造成排便并有助于排便的轴向力。我们的目的是通过使用直肠内球体或固定在距肛门边缘8、6或4 cm并连接到轴向力和位移传感器的乳胶球囊测量轴向直肠肛门力来研究这些机制。在12名无症状妇女和12名排便困难症状的妇女中，在基线时（即休息时）和操作期间（即挤压，模拟撤离和Valsalva动作）测量了乳胶球囊中的直肠肛门力和直肠压力。还通过测压法评估了肛门的静息压力和挤压压力，在对照患者和实验患者中相似。静止时，轴向直肠肛门力向内指向并随着装置接近肛门边缘而增加。对照患者在模拟驱逐和瓦尔萨尔瓦（Valsalva）动作期间挤压并施加向外的力时，会增加这种向内的力。机动过程中的力变化也受设备位置的影响，在距边缘4 cm处最大。在实验患者中，静息力和所有操作过程中的力变化均低于对照组。实验患者的瓦尔萨尔瓦（Valsalva）动作期间的直肠压力也低于对照组患者，提示推进力受损。总而言之，一部分有排便症状的女性不仅在驱逐期间而且在Valsalva动作期间以及在挤压（即收缩）盆底肌肉时其轴向力均较弱，这提示盆底肌普遍无力。

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