Defecography and proctography - Results of 744 patients
Defecography and proctography - Results of 744 patients
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DOI：
10.1007/bf02053989
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发表时间：
1996-08-01
影响因子：
3.9
通讯作者：
Wexner, SD
中科院分区：
文献类型：
--
作者：
Agachan, F;Pfeifer, J;Wexner, SD
目得：在排空过程中盆腔和直肠内动态变化的放射成像已被认为是一种有价值的评估方法。本研究旨在评估可能存在排便障碍的患者的排便造影结果的发生率和临床意义。材料和方法：所有的排粪造影研究都由一位熟悉患者病史和体格检查结果的结直肠外科医生进行回顾。研究结果：1988年7月至1995年7月，744例患者（566例女性和178例男性），平均年龄为63.5岁（范围，12-95）进行了排便造影和直肠造影检查。446例（60%）患者被诊断为便秘，123例（16.5%）大便失禁，42例（5.6%）直肠脱垂，82例（11%）直肠疼痛，51例（6.9%）合并了以上诊断。虽然这些评估中有93例（12.5%）被认为是正常的，但61例（8%）显示直肠脱垂，191例（25.7%）直肠前突，82例（11%）乙状结肠突出和94例（12.6%）肠套叠;在223例（30%）患者中，注意到这些结果的组合。耻骨直肠肌异常收缩患者便秘发生率显著高于其他症状（P < 0.0001）。结论：排粪造影可以发现大多数排便障碍患者的异常。直肠前突、乙状结肠前突和肠套叠的发生率较高。必须注意不要严格根据放射学检查结果治疗患者。
PURPOSE: Radiographic imaging of dynamic changes within the pelvic cavity and rectum during evacuation has been recognized as a valuable method of assessment. This study was designed to assess the incidence and clinical significance of defecographic findings in patients with possible evacuation disorders. MATERIALS AND METHODS: All defecographic studies were reviewed by a single colorectal surgeon familiar with patients' histories and physical findings. RESULTS: Between July 1988 and July 1995, 744 patients (566 females and 178 males) with a mean age of 63.5 (range, 12-95) years had defecographic and proctographic examination. Four hundred forty-six (60 percent) patients were diagnosed who complained of constipation, 123 (16.5 percent) of fecal incontinence, 42 (5.6 percent) of rectal prolapse, 82 (11 percent) of rectal pain, and 51 (6.9 percent) had a combination of more than one of these diagnoses. Although 93 (12.5 percent) of these evaluations were considered normal, 61 (8 percent) revealed rectal prolapse, 191 (25.7 percent) rectocele, 82 (11 percent) sigmoidocele, and 94 (12.6 percent) intussusception; in 223 (30 percent) patients, a combination of these findings was noted. Patients with paradoxical puborectalis contraction had an extremely high frequency of constipation compared with other symptoms (P < 0.0001). CONCLUSION: Defecography can reveal abnormalities in the majority of patients with evacuatory disorders. There was a high incidence of rectocele, sigmoidocele, and intussusception. Care must be taken not to treat patients strictly based on radiographic findings.