目的 研究老年功能性便秘(functional constipation,FC)患者肛门直肠动力学特征及影响因素.方法 选取上海市奉贤区中心医院2012年2月—2016年3月收治的老年FC患者50例为便秘组,并成立健康组50例,2组人员均采用匹兹堡睡眠质量指数问卷(PSQI)进行睡眠质量检测、肛门直肠动力学检测和问卷调查.结果 便秘组肛管静息压、肛门最大收缩压、松弛压、肛管长度、直肠感知临界值、排便临界值、疼痛临界值和直肠肛门抑制放射最小容积均显著高于健康组(P<0.05);便秘组PSQI评分显著高于健康组(P<0.05);采用Logistic多因素回归分析表示PSQI评分、饮食辛辣、精神状态、长期坐立、排便异常、药物使用和痔疮是老年FC的危险因素(P<0.05).结论 老年FC患者肛门直肠动力学为异常,睡眠质量较差;PSQI评分、饮食辛辣、精神状态欠佳、长期坐立、排便异常、药物使用和痔疮是老年FC的危险因素.%Objective To investigate the anorectal kinetics and functional factors in elderly patients with functional constipation (FC).Methods Fifty elderly patients with FC admitted to the department of gastroenterology between February 2012 and March 2016 were selected as the constipation group while another 50 cases as the healthy group according to physical examination results at our hospital. Questionnaires based on the Pittsburgh sleep quality index (PSQI) were used for the assessment of sleep quality and anorectal manometry in the two groups. Results The anal resting pressure, anal maximum systolic pressure, relaxation pressure, anal canal length, rectal perception threshold, critical bowel threshold, pain threshold and rectum and anus inhibition volume in the constipation group significantly surpassed those of the healthy group (P<0.05). The PSQI score of the constipation group was significantly higher than that of the healthy group (P<0.05). Logistic regression analysis showed that the PSQI score, spicy foods, mental status, sedentariness, defecation kinetics abnormalities, drug use and hemorrhoids were risk factors for FC in the elderly (P<0.05).Conclusion Elderly patients with FC have abnormal anorectal dynamics and poor sleep quality. PSQI scores, spicy foods, mental state, a sedentary lifestyle, abnormal defecation dynamics, drug use and hemorrhoids are risk factors for elderly patients with FC.
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