伴有肛周疾病的炎症性肠病患者肛门功能及生活质量分析

目的分析肛周疾病对炎症性肠病（IBD）患者肛门直肠功能和生活质量的影响。 方法回顾性分析2018年6月至2020年6月淮安市第二人民医院收治的伴有肛门不适的53例IBD患者（IBD组）。其中CD43例,UC10例。包括肛瘘35例,大便失禁15例,肛门纤维化8例。选择同期来淮安市第二人民医院体检的健康人20名作为健康对照组。通过肛门直肠测压对IBD患者和健康对照组受试者肛门功能进行评估并进行比较。采用炎症性肠病患者生活质量量表（IBDQ）评分对IBD患者生活质量进行评估。 结果IBD患者与健康对照组最大肛门静息压、最大挤压压、直肠容量感觉阈值、最大耐受容量、肛管抑制反射阳性水平差异均无统计学意义（P均>0.05）。大便失禁的IBD患者最大肛门静息压、IBDQ评分均低于非大便失禁的IBD患者,且差异均有统计学意义（P<0.05）。CD与UC患者IBDQ评分差异无统计学意义（P>0.05）;大便失禁IBD患者IBDQ评分低于非大便失禁IBD患者,且差异有统计学意义（P<0.05）。 结论合并肛周疾病的IBD患者肛门直肠功能受损,大便失禁的患者生活质量差。

Analysis of anal function and quality of life in patients with inflammatory bowel disease associated with perianal diseases

Objective:To analyze the effect of perianal diseases on anorectal function and quality of life in patients with inflammatory bowel disease (IBD). Methods:A total of 53 IBD patients with anal discomfort (IBD group) admitted to The Second People's Hospital of Huai'an City from June 2018 to June 2020 were retrospectively analyzed. Among them, 43 cases were Crohn's disease (CD) and 10 cases were ulcerative colitis (UC). There were 35 cases of anal fistula, 15 cases of fecal incontinence and 8 cases of anal fibrosis. Twenty healthy people who came to The Second People's Hospital of Huai'an City for physical examination in the same period were selected as healthy control group. Anal function of IBD patients and healthy control subjects was evaluated and compared by anorectal manometry. The quality of life of IBD patients was assessed by Inflammatory Bowel Disease Quality of Life Scale (IBDQ). Results:There were no statistically significant differences between IBD patients and healthy controls in the maximum anal resting pressure, maximum squeezing pressure, rectal volume sensory threshold, maximum tolerated volume and positive level of anal canal inhibitory reflex (all P>0.05). The maximum anal resting pressure and IBDQ score of IBD patients with fecal incontinence were lower than those of IBD patients without fecal incontinence, with statistically significant differences (P<0.05). There was no statistically significant difference in IBDQ score between CD and UC patients (P>0.05). IBDQ score of IBD patients with fecal incontinence was lower than that of IBD patients without fecal incontinence (P<0.05). Conclusion:The anorectal function of IBD patients with perianal diseases is impaired, and the quality of life of patients with fecal incontinence is poor.