항문-직장 내압검사상 나타나는 치핵 및 만성치열 환자의 초저속파
The Ultraslow Wave in Patients with Hemorrhoids and Chronic Anal Fissure
김진천, 김숙영, 김희철, 유창식, 박상규,
소속 상세정보
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
김숙영 ( Kim Suk-Young )
울산대학교 의과대학 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
박상규 ( Park Sang-Kyu )
울산대학교 의과대학 외과학교실
KMID : 0356720010170050227
Abstract
Purpose: We assessed the nature of the ultraslow wave in patients with hemorrhoids and chronic anal fissure according to clinical findings and manometry in this study.
Methods: Three hundred and thirty-three patients with hemorrhoids and 88 patients with chronic anal fissure were included. Anorectal manometry was performed according to a modified protocol based on the Coller’s study. The ultraslow wave was determined as an undulating wave equal or less than two waves/min.
Results: The ultraslow wave was found in 142 of the 333 patients (42.6%) with hemorrhoids and 44 of the 88 patients (50%) with chronic anal fissure. The pressure variables (maximal resting and squeeze pressure, rectal pressure at the beginning of rectoanal inhibitory reflex, rectal pressure on sense or fullness of balloon) were significantly higher in patients with ultraslow wave than in those without (P＜0.001∼0.05). The ultraslow wave frequency was inversely proportional to aging and to its amplitude (P=0.006 and ＜0.001, respectively). Maximal squeeze pressure was closely correlated with maximal resting pressure in a multiple regression analysis (P=0.002). The defecation difficulty and anorectal bleeding were more frequent in patients with ultraslow wave than those without in the hemorrhoids (P=0.008 and 0.021, respectively).
Conclusion: The ultraslow wave closely correlates with an anorectal pressure and frequently occurs in patients with hemorrhoids and chronic anal fissure. It appears to be associated with the internal anal sphincter as well as with the external anal sphincter and levator ani muscles.
키워드
초저속파;내압검사;치핵;치열
Ultraslow wave;Manometry;Hemorrhoids;Fissure
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