数字直肠检查可以识别失能性障碍的亚型以及高分辨率无直肠测量吗?
Philippe Onana Ndong1, Karine Baumstarck2, Véronique Vitton3
1Service de Gastroentérologie, Hôpital L'Archet 2 Centre Hospitalier Universitaire de Nice Nice France.
JGH open : an open access journal of gastroenterology and hepatology
|January 13, 2025
概括
数字直肠检查 (DRE) 有效地诊断异能障碍 (DD) 亚型,为3D高清无直肠测量 (3D-HRAM) 提供了具有成本效益的替代方案. 这种方法对大多数亚型显示出良好的一致性,可能降低医疗保健成本.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 诊断成像 诊断成像 诊断成像
背景情况:
- 诊断失调性障碍 (DD) 通常依赖于3D高清无直肠测量 (3D-HRAM),这在成本,可访问性和转诊时间方面提出了挑战.
- 数字直肠检查 (DRE) 是一种实用,经济的替代方法来识别DD.
研究的目的:
- 评价DRE在将患有失协性疾病的患者分类为Rao分类所定义的四个亚型中的有效性.
- 为了比较DRE的诊断准确度与DD亚型的3D-HRAM.
主要方法:
- 一项回顾性单心研究,涉及200名通过3D-HRAM诊断出DD的患者.
- 患者接受了临床医生对3D-HRAM结果的盲目的DRE,并进行了统计分析,以将DRE发现与3D-HRAM分类相关联.
主要成果:
- 在DD诊断方面,DRE和3D-HRAM之间的总体一致性很大 (Kappa = 0.658).
- DRE显示了I,II和IV亚型的实质性相关性 (卡帕=0.679,0.741,0.649) 和III亚型的中等相关性 (卡帕=0.325).
结论:
- DRE是一个令人满意的工具来诊断四种类型的失调性障碍.
- 改善DRE培训可以减少对3D-HRAM的依赖,减少DD诊断的经济和后勤负担.
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