【摘要】 目的 研究直肠肛门瘘手术前后肛肠动力学的变化。方法 对37例肛瘘患者手术前后用直肠肛管测压法检测直肠肛门反射(RAR)、肛管最大收缩压(AMCP)、肛管最长收缩时间(ALCT)、直肠静息压(RRP)、肛管静息压(ARP)5项技术指标。对肛瘘手术前后及其低位、高位手术前后、低位与高位术后进行比较，并与30名正常人进行对比。结果 术后RAR完全恢复并敏感率提高(P<0.01)，与正常人无差异(P>0.05)；AMCP与术前无差异(P>0.05)，比正常人明显降低(P<0.01)；ALCT与术前无差异(P>0.05)，比正常人延长(P<0.05)；RRP术后降低(P<0.01)，与正常人无差异(P>0.05)；ARP术后降低(P<0.01)，比正常人亦显著降低(P<0.01)。结论 肛瘘疾病及肛管内外括约肌损伤的严重程度对肛门的闭紧功能产生直接影响，尤其是高位肛瘘可能引起部分患者的气体或液体失禁。

Kinetic changesof the anorectum before and after

    the anal fistula operation

ZHANG Rongzai, LIN Dapeng, YU Zhitao. Department of Surgery, People's Hospital of Meizhou, Guangdong Meizhou 514031

【 Abstract】 Objective To study the kinetic changes ofthe anorectum before and after anal fistula operation. Methods The anorectal pressure wasmeasured with five indexes, such as rectalanal reflex (RAR), anal maximal contractionpressure (AMCP), anal longest contraction time (ALCT), rectalrest pressure (RRP) andanalrest pressure (ARP), in 37 cases of anal fistula. The comparisons, between pre- andpost-operation, pre- and post-operation of low position, pre- and post-operation of highposition, post-operation of high position and that of low position, 37 patients and 30normal people, were made.Results After the operation, RAR of cases was recoveredcompletely, its sensitive rate elevated (P<0.01) and had no difference with normalpeople. AMCP of patients was not different with pre-operation (P>0.05) butsignificantly lower than that of normal people (P<0.01), and so was ALCT (P>0.05),significantly longer than that of normal people (P<0.01). RRP decreased significantlyafter operation (P<0.01) and had no difference with that of normal people (P>0.05).ARP decreased significantly compared with that of pre-operation and normal people(P<0.01).Conclusions The severity of the anal fistula and the internal orexternal anal sphincter injury has a direct influence on anal contractive function.Especially high position fistula may lead to anal incontinence in some patients.

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