文档介绍：治疗便秘动力学分析
pph手术治疗出口梗阻型便秘心理与生物动力学分析
秦震声1张建1 周传文赵耀刘业六周宝祥
(1南京医科大学附属淮安医院胃肠外科,淮安223300)
摘要:目的探讨出口梗阻型便秘可能的发病机制,为pph手术治疗出口梗阻型便秘寻找理论依据。方法 19例诊断为出口梗阻型便秘的患者为病例组,同时选择9例健康志愿者作为对照组。患者术前及术后、对照组均接受抑郁汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA) 和肛门直肠动力学检测。结果各组肛管功能长度无明显差异; 术后A组(15天)最低感知阈值、最大耐受阈值、直肠排便阈值均明显低于术前及对照组。术后B组(90天)最低感知阈值、最大耐受阈值、直肠排便阈值显著回升。精神评价方面,HAMA及HAMD总分术后均呈现先降后升的改变。结论出口梗阻性便秘患者存在肛门直肠动力学障碍和精神心理障碍, PPH手术治疗可显著改善上述情况,具体机制不详。
关键词:出口梗阻型便秘;PPH;直肠动力学
Clinical study of the psychological and biomechanical factor for prolapse and hemorrhoids (PPH) in the treatment of outlet obstruct tive constipation QIN Zhensheng1,ZHANG Jian1,ZHOU Chuanwen2,ZHAO Yao,LIU Yeliu,ZHOU Baoxiang
Department of Gastrointestinal Surgery,Afiliated Re Hospital,Nanjing University
School of Medicine,Huaian 2233000,Jiangsu province China
Abstract Objective To study the pathogenesis of outlet obstructive constipation ( OOC) to find the theoretical basis of PPH . Methods 19 patients diagnosed as OOC were patients group . 9 healthy controls lack of symptoms of defecation disorders were control group . All research objects were undergone an examination of anorectalm anometry ( ARM) and Hamilton Scale (HAMD, HAMA). Results There w as no obvious difference in the length of anal canal between patients group and control group. The sensitivity threshold, maximum tolerated threshold, defecation threshold in postoperative group A