{"id":113071,"date":"2018-03-11T10:40:19","date_gmt":"2018-03-11T10:40:19","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/test-manometrico-para-la-seleccion-de-pacientes-con-fisura-anal-cronica-candidatos-a-tratamiento-conservador\/"},"modified":"2018-03-11T10:40:19","modified_gmt":"2018-03-11T10:40:19","slug":"test-manometrico-para-la-seleccion-de-pacientes-con-fisura-anal-cronica-candidatos-a-tratamiento-conservador","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/murcia\/test-manometrico-para-la-seleccion-de-pacientes-con-fisura-anal-cronica-candidatos-a-tratamiento-conservador\/","title":{"rendered":"Test manom\u00e9trico para la selecci\u00f3n de pacientes con fisura anal cr\u00f3nica candidatos a tratamiento conservador"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Jose Gil Martinez <\/strong><\/h2>\n<p>Prop\u00f3sito.  desarrollar un test (utilizando manometr\u00eda anorrectal) para seleccionar a aquellos pacientes  con fisura anal cr\u00f3nica (fac) que probablemente no se beneficien de esfinterotom\u00eda qu\u00edmica (eq)  y deban de someterse a un tratamiento m\u00e1s agresivo.   material y m\u00e9todos.  se midieron los cambios en la presi\u00f3n del esf\u00ednter anal de 187 pacientes con fac y en 25 sujetos sanos. Los pacientes fueron secuencialmente tratados con inyecciones de toxina botul\u00ednica o pomadas de nitroglicerina o diltiazem, durante dos meses. Se determinaron las tasas de curaci\u00f3n y su relaci\u00f3n con los cambios en la presi\u00f3n anal.  resultados.   la tasa global de curaci\u00f3n fue del 53%. Las probabilidades de curaci\u00f3n se asocian  con un incremento  en el porcentaje de cambio desde la presi\u00f3n de reposo a la de contracci\u00f3n (\u00edndice pi) superior al 150%, similar a los sujetos del grupo control. Los fracasos en la eq se asociaron a cifras de pi inferiores a 150%  conclusiones.   la relaci\u00f3n entre las presiones de reposo y de contracci\u00f3n voluntaria, puede ser predictiva de curaci\u00f3n en fac, lo que permite la selecci\u00f3n de los pacientes con alto riesgo de fracaso del tratamiento conservador.  palabras clave: esfinterotom\u00eda qu\u00edmica. \u00edndice p.I. Manometr\u00eda anorrectal.    purpose:   we developed a screening test (using anal manometry) to separate those patients with chronic anal fissure (caf) that are unlikely to benefit from chemical sphincterotomy (cs) and should undergo a more aggressive treatment.   methods:   changes in pressure, of the anal sphincter in 187 patients with caf and 25 healthy subjects were measured. Patients were then sequentially treated with botulin toxin injections or ointments of either nitroglycerine or diltiazem for two months. The cure rate and its relationship with changes in anal pressure were determined.   results.   the overall cure rate was 53%. The probability of healing was associated with an increase in the percentage change between resting and squeeze pressure (pi index) higher than 150 %, similar to that of the control subjects. Failure of cs was observed in patients with a lower pi.   conclusions:   the ratio resting\/voluntary contraction pressure may be predictive of healing in caf, thus allowing the selection of patients at high risk of failure of conservative treatment.    keywords: chemical sphincterotomy, pi index. Anorectal manometry<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Test manom\u00e9trico para la selecci\u00f3n de pacientes con fisura anal cr\u00f3nica candidatos a tratamiento conservador<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Test manom\u00e9trico para la selecci\u00f3n de pacientes con fisura anal cr\u00f3nica candidatos a tratamiento conservador <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Jose Gil Martinez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 19\/07\/2012<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Pascual Parrilla Paricio<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: ricardo Robles campos <\/li>\n<li>graciela Valero navarro (vocal)<\/li>\n<li>Antonio Arroyo sebastian (vocal)<\/li>\n<li>Rafael Alos company (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Jose Gil Martinez Prop\u00f3sito. desarrollar un test (utilizando manometr\u00eda anorrectal) para seleccionar a aquellos pacientes con fisura [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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