关键词: 便秘；结肠疾病, 功能性；肛管；直肠；动力学

Abstract: Background　As a disease with complex etiology and high incidence，functional constipation（FC） has become an important health problem affecting the quality of work and life of people.Anorectal manometry is an important technique for detecting anorectal function in patients with constipation.It can identify，quantify and evaluate the function of anal canal and rectum，providing a basis for the selection of treatment option and evaluation of the treatment efficacy.It has been widely used in the diagnosis and treatment of FC.Objective　To give an anorectal manometry analysis of patients with FC by sex，age and accompanying symptoms，offering evidence for its prevention，diagnosis，and treatment.Methods　We enrolled 95 cases of FC who underwent solid-state high-resolution anorectal manometry from Gastrointestinal Motility Room，the First Affiliated Hospital of Xi'an Jiaotong University during June 2016 to December 2017.All of them were diagnosed according to the Rome Ⅲ diagnostic criteria for FC.We made comparisons between them in terms of sex，age（old people are those who aged 60 or over in accordance with Provisional Guidelines on Standard International Age Classifications），types of stool（assessed by the Bristol Stool Scale） and accompanying symptoms（difficult defecation，incomplete defecation，abdominal distension，abdominal pain），and anorectal manometry parameters〔anal resting pressure，anal canal high-pressure band width，maximum anal squeeze pressure，maximum anal squeeze pressure duration，rectal sensory thresholds（first sensation，desire and urgency to defecate，urgency to defecate，and maximal tolerable volume），rectal pressure and anal residual pressure，anorectal pressure difference，percent anal relaxation〕.Results　There were significant differences between males and females in anal canal resting pressure，maximum anal squeeze pressure duration，anal residual pressure，rectal pressure and percent anal relaxation（P<0.05）．There were no significant differences between males and females in anal canal high-pressure band width，maximum anal squeeze pressure，first sensation，desire and urgency to defecate，maximal tolerable volume，and anorectal pressure difference（P>0.05）．Compared with the elderly group（aged 60 or over），non-elderly group（aged less than 60） had lower anal canal resting pressure，less first sensation，desire and urgency to defecate，percent anal relaxation（P<0.05），but similar anal canal high-pressure band width，maximum anal squeeze pressure，maximum anal squeeze pressure duration，maximal tolerable volume，anal residual pressure，rectal pressure and anorectal pressure difference（P>0.05）．Types of stool，difficult defecation and incomplete defecation were not associated with the values of anal resting pressure，maximum anal squeeze pressure and rectal sensory thresholds（P>0.05）．Abdominal distension and abdominal pain were associated with greater desire to defecate（P<0.05），but not associated with anal resting pressure，maximum anal squeeze pressure，first sensation，urgency to defecate，and maximal tolerable volume（P>0.05）．Male，aged 60 or over，and difficult defecation were associated with higher incidence of paradoxical contraction of the anal sphincter during defecation（P<0.05）．But types of stool，incomplete defecation，abdominal distension，and abdominal pain were not associated with the incidence of paradoxical contraction of the anal sphincter during defecation（P<0.05）．Conclusion　The main anorectal manometry results are pelvic floor dysfunction and inadequate defecatory propulsion in females with FC.Those FC patients aged 60 or over are found with increased prevalence of pelvic floor dysfunction and rectal hyposensitivity，indicating that the two factors are closely involved in the development of FC in old people.Accompanying abdominal distension and pain are closely associated with abnormally increased rectal volume thresholds and decreased rectal sensitivity.FC has complex etiology and high incidence，which severely impairs the quality of people's work and life.FC is associated with abnormal anal canal pressure and sensory function.The anorectal manometry analysis of FC helps to identify，quantify and evaluate the anal and rectal function，and to determine the pathogenesis of FC，offering a reference for the selection of treatment regimen and evaluation of the efficacy.

Key words: Constipation；Colonic diseases, functional；Anal canal；Rectum；Kinetics