The Application Of Anorectal Manometry On The Diagnosis And Treatment Of Anterior Rectocele Constipation

Objective:To explore the correlation between the high pressure of anal canal during defecation and the formation of rectocele.Then,analyze and put forward corresponding evaluation index,to clarify the advantages of biofeedback in the treatment of anterior rectocele constipation.Methods:(1)70 healthy female volunteers were selected in the Affiliated Hospital of Chengde Medical College between Nov.2015 and Sep.2017 as the control group,and 80 patients with the criteria of rectocele selection were selected as the case group,the anorectal pressure of two groups were measured,then,compared the data about the anorectal pressure of two groups and gained it.(2)The patients with rectocele were divided into one group of less than 3 cm of the protrusion of the rectum and the other group of more than 3 cm with the protrusion of the rectum.Two groups were accepted the biofeedback,before and after treatment,anorectal manometry was measured,the changes of anorectal manometry before and after treatment were compared.At the same time,the patients of two groups were conducted evaluation of clinical efficacy.Results:(1)The women with anterior protrusive constipation were aged between 40 and 70 years old,accounting for 80%.(2)The anal canal defecation diastolic pressure of the women with anterior protrusive constipation was higher than the healthy women(P<0.01).The anal canal resting pressure?the maximum systolic pressure?the anal rectal resting pressure?the rectal systolic pressure of the women with anterior protrusive constipation compared with the healthy women(P>0.05)and action correlation analysis(P<0.01).(3)The anal canal defecation diastolic and the anal canal resting pressure were positively correlated with the occur of rectocele,the difference was statistically significant(P<0.01).The maximum systolic pressure?the rectal resting pressure and the rectal systolic pressure were no correlation with the occur of rectocele,the difference was not statistically significant(P>0.05).(4)After treatment with mild moderate biofeedback group,the anal canal defecation diastolic pressure was lower than before the treatment.The anal canal resting pressure?the maximum systolic pressure?the anal rectal resting pressure?the rectal systolic pressure compared with before the treatment(P>0.05)and the action correlation analysis(P<0.01).(5)After treatment with serves biofeedback group,the anal canal defecation diastolic pressure was lower than before the treatment(P<0.05).The anal canal resting pressure?the maximum systolic pressure?the anal rectal resting pressure?the rectal systolic pressure compared with before the treatment(P>0.05)and the action correlation analysis(P<0.05).(6)By symptom grade,After treatment with mild moderate biofeedback group compared with the before treatment(P<0.01).After treatment with serves biofeedback group compared with the before treatment(P<0.01).(7)For the patients with mild anterior protrusive constipation,biofeedback effected to 76.7%.For the patients with severe anterior protrusive constipation,biofeedback effected to 53.3%.The total effective rate of the two groups was 65%.Conclusion:High pressure in the anal canal and the anterior protrusive constipation were closely related.The biofeedback treatment had exactly effect on the anterior protrusive constipation.