目的:与高分辨率测压(HRM)技术相关的伦敦协议(LP)和分类技术的发展更新并增强了肛门直肠疾病的诊断性医疗设备。本研究旨在评估水灌注HRM下的LP再现性,在灌注人力资源管理下,基于3D和健康比较研究提供正常数据和新参数。
方法:根据静息时的LP,50位健康(25华氏度)接受了水灌注36通道HRM,挤压,咳嗽,推,还有直肠感觉.另外的3D测压参数是:压力-体积(PV)104mmHg2。厘米(休息,短而长的挤压,咳嗽);最高和最低压力不对称(静息,短挤压,和咳嗽)。补充参数(CP)为:静息(平均压力,功能性肛管长度);短挤压(平均和最大绝对挤压压力),耐力(疲劳率,疲劳率指数,维持能力);咳嗽(肛门直肠梯度压力);推动(直肠-肛门梯度压力,肛管松弛百分比);直肠肛门抑制性反射(肛管松弛百分比)。
结果:性别没有差异:休息(LP,CP,和3D);短挤压(最高压力不对称);耐力(CP);咳嗽(CP,最高和最低压力不对称);推动(梯度压力);直肠感觉。男性压力较高:短挤(最大增量,绝对,和平均压力,PV,最低压力不对称);长挤压(PV);咳嗽(肛管和直肠最大压力,肛管PV);推动(肛管和直肠最大压力)。女性肛管松弛率较高(推挤)。
结论:LP再现性在水灌注人力资源管理下是可行的,比较研究可以为数据集扩展带来相似性。新的3D参数需要对健康和更大的数据进行进一步研究,以进行验证和疾病比较。
结论:•伦敦协议和分类与人力资源管理(软件和探针)的技术发展相结合,完善了肛门直肠疾病的诊断设备。•在伦敦分类作为辅助诊断工具之前,新颖的3D和深化了对测压参数的分析。•根据伦敦议定书在灌注高分辨率系统下对健康志愿者进行比较可以建立等效点。
OBJECTIVE: London Protocol (LP) and Classification allied to high-resolution manometry (HRM) technological evolution has updated and enhanced the diagnostic armamentarium in anorectal disorders. This study aims to evaluate LP reproducibility under water-perfused HRM, provide normal data and new parameters based on 3D and healthy comparison studies under perfusional HRM.
METHODS: Fifty healthy (25 F) underwent water-perfused 36 channel HRM based on LP at resting, squeeze, cough, push, and rectal sensory. Additional 3D manometric parameters were: pressure-volume (PV) 104mmHg2.cm (resting, short and long squeeze, cough); highest and lowest pressure asymmetry (resting, short squeeze, and cough). Complementary parameters (CP) were: resting (mean pressure, functional anal canal length); short squeeze (mean and maximum absolute squeeze pressure), endurance (fatigue rate, fatigue rate index, capacity to sustain); cough (anorectal gradient pressure); push (rectum-anal gradient pressure, anal canal relaxation percent); recto-anal inhibitory reflex (anal canal relaxation percent).
RESULTS: No difference to genders: resting (LP, CP, and 3D); short squeeze (highest pressure asymmetry); endurance (CP); cough (CP, highest and lowest pressure asymmetry); push (gradient pressure); rectal sensory. Higher pressure in men: short squeeze (maximum incremental, absolute, and mean pressure, PV, lowest pressure asymmetry); long squeeze (PV); cough (anal canal and rectum maximum pressure, anal canal PV); push (anal canal and rectum maximum pressure). Anal canal relaxation was higher in women (push).
CONCLUSIONS: LP reproducibility is feasible under water-perfused HRM, and comparative studies could bring similarity to dataset expansion. Novel 3D parameters need further studies with healthy and larger data to be validated and for disease comparisons.
CONCLUSIONS: • London Protocol and Classification allied with the technological evolution of HRM (software and probes) has refined the diagnostic armamentarium in anorectal disorders. • Novel 3D and deepening the analysis of manometric parameters before the London Classification as a contributory diagnostic tool. • Comparison of healthy volunteers according to the London Protocol under a perfusional high-resolution system could establish equivalence points.