항문내압 검사의 배변지수에 의한 치골직장근 이완부전증의 진단
Diagnosis of Non-relaxing Puborectalis Syndrome by using the Manometric Defecation Index
김태원, 성무경, 유영범, 성무경, 유영범,
소속 상세정보
김태원 ( Kim Tae-Won )
건국대학교 의과대학 외과학교실
성무경 ( Seong Moo-Kyung )
건국대학교 의과대학 외과학교실
유영범 ( Yoo Young-Bum )
건국대학교 의과대학 외과학교실
성무경 ( Seong Moo-Kyung )
건국대학교 의학전문대학원 외과학교실
유영범 ( Yoo Young-Bum )
건국대학교 의학전문대학원 외과학교실
KMID : 0356720070230060410
Abstract
Purpose: Currently, various tools are used for the diagnosis of nonrelaxing puborectalis syndrome (NRPRS), one of major causes of chronic constipation. Defecography, electromyography (EMG), balloon expulsion test, and a colon transit time study one examples of such tools, but none can be said to be the most accurate and effective one. A diagnosis is only made when two or more examinations show positive findings simultaneously. The aim of this study is to assess the correlation between EMG and the manometric defecation index (DI), which is a relatively new parameter, for the diagnosis of NRPRS.
Methods: Forty-two chronically cornstipated patients without any history of anal or abdominal surgery underwent both anorectal manometric and EMG tests. The manometric defecation index (DI) was defined as the ratio between the peak rectal pressure and the peak anal pressure when the pressures were measured simultaneously during push by the catheter with longitudinally arranged side holes. The ratio of EMG activity was defined as the ratio between the peak amplitude during push and the peak amplitude during rest when EMG activities were measured by using an anal plug electrode. The two variables were compared prospectively, and their correlation was analyzed.
Results: The manometric DI and the ratio of EMG activit in 42 patients were 0.80±0.75 and 1.50±0.65, respectively. The correlation coefficient between the two variables was ?0.50 (P= 0.001).
Conclusions: The manometric DI and the ratio of EMG activit were correlated significantly. Therefore, it can be said that the anorectal manometric test can replace the EMG test for diagnosis of NRPRS, which has less convenient access for most colorectal surgeons. J Korean Soc Coloproctol 2007;23:410-415
키워드
치골직장근 이완부전증;배변지수
NRPR syndrome;Manometric defecation index
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