质疑Hirschsprung病发病率与直肠活检指示之间的相关性
Go Miyano1, Takamasa Suzuki1, Risa Masuda1
1Pediatric Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
添加药使用作为直肠粘膜/下粘膜活检 (RMSBx) 的指示,增加了Hirschsprung.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 赫施普朗格病 (HD) 的诊断依赖于直肠粘膜/粘膜下部活检 (RMSBx).
- 在患有慢性便秘的儿科患者中使用RMSBx的适应性已经发展.
- 以前的适应症主要集中在阴囊使用 (E+),新的指导方针包括药使用 (L+).
研究的目的:
- 审查和分析RMSBx在诊断儿科患者的HD中的适用性.
- 调查改变RMSBx指示对检测到的HD发病率的影响.
- 评估与不同RMSBx适应症相关的诊断产量和患者结果.
主要方法:
- 对562名儿科患者 (1-15岁) 的病历回顾性审查,他们被评估为慢性便秘 (2012-2022年).
- 在以前使用阴囊的患者 (E+) 和符合新药使用标准 (L+) 的患者之间,RMSBx率和HD发病率的比较.
- 对L+患者的亚组分析基于并发的阴囊使用 (L+E+与L+E-).
主要成果:
- 在使用药的组中,RMSBx的发病率明显高 (27.6%),而在使用阴囊的组中则高 (8.8%).
- 虽然脱剂组的HD发病率在数值上更高 (31.0%对22.2%),但这种差异在统计学上并不显著.
- 手术后的结果,包括排便频率和需要药的情况,在两组之间没有显著差异.
结论:
- 扩大RMSBx的适用范围,包括药的使用,可能会增加赫施普隆病的检测率.
- 进一步评估诊断标准是必要的,以准确诊断HD.
- 这项研究表明,目前的迹象可能低估了HD的真实发病率.
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