便秘患者难以排便:通过微创诊断测试进行诊断
Giuseppe Chiarioni1, Christian Lambiase2, William E Whitehead3
1Division of Gastroenterology B, AOUI Verona, Verona, Italy; UNC Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
概括
一个紧张的问题和增强的数字直肠检查可以准确地查慢性便秘患者的排便障碍. 这些方法改善了管理和适当的转诊,以进行生物反治疗.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 生理学 生理学 生理学
背景情况:
- 排便障碍 (DD) 是慢性便秘的常见原因之一.
- 准确诊断DD通常需要直肠生理学测试.
- 耐火性便秘通常需要专门的诊断方法.
研究的目的:
- 评估SQ和增强数字直肠检查 (DRE) 的诊断准确性和预测价值.
- 评估SQ和增强DRE在慢性便秘 (CC) 患者中识别排便障碍 (DD) 的几率比率 (OR).
主要方法:
- 238名便秘患者被纳入该研究.
- 患者接受了SQ,增强DRE和气球疏散测试.
- 进行了直肠计量,以诊断失能性排便和不充分的推进.
主要成果:
- "门肌肉"的反应与异能排便 (OR 13.6,准确率78.5%) 和不充分的推进 (OR 5.85,准确率66.4%) 有显著的关联.
- 在增强的DRE中",门放松失败"预测了失协性排便 (OR 21.4,准确率为73.1%).
- 在增强DRE的"失败的腹部收缩"强烈预测了不足的推进 (OR>100,准确率为97.1%).
结论:
- 这项研究支持使用SQ和增强DRE用于首次查便秘患者的DD.
- 这些非侵入性方法可以增强患者管理,并优化生物反治疗的转诊.
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