结肠运输试验36例误诊分析

2012-10-17夏建余

浙江医学教育 2012年3期

关键词：功能

夏建余

(杭州市第一人民医院吴山院区，浙江杭州 310002)

·基础与临床研究·

结肠运输试验36例误诊分析

夏建余

(杭州市第一人民医院吴山院区，浙江杭州 310002)

目的：分析结肠运输试验误诊的原因，探讨结肠运输试验的检查注意事项。方法回顾性分析结肠运输试验36例误诊病例的临床及影像资料，对误诊原因进行归类。结果36例误诊患者中，15例在测试期间使用影响肠功能的药物；6例因胃肠炎出现腹泻；5例大量进食高纤维素性或导泻类食物；3例有严重抑郁、焦虑表现；2例有高强度运动史；1例大量饮用浓茶；1例服减肥茶；3例无明确原因。结论影响结肠运输试验的因素复杂多样，应尽量消除对检查可能不利的影响，以降低误诊率。

结肠运输试验；便秘；误诊

Abstract：[Objective] To investigate the reasons of misdiagnosis and matters needing attention for colonic transit study. [Method] The causes of misdiagnosis for colonic transit study in 36 cases were retrospectively analyzed and classified. [Result] In 36 patients clinically diagnosed as colonic slow transit constipation , which were misdiagnosed by colonic transit study, 15 cases used the drug with influencing the bowel function during the test, 6 cases appeared diarrhea because of gastroenteritis; 5 cases ate the food with high much cellulose or with catharsis; 3 cases had the performance of severe depression, anxiety; 2 cases had the history of high strength movement; 1 case was drinking strong tea; 1 case continued to take an anti obesity drug ; 3 cases had no specific cause. [Conclusion] The causes of misdiagnosis for colonic transit study are complicated and various, to reduce diagnostic errors ,should try to eliminate adverse factors.

Keywords：colon transit study; constipation; diagnostic errors

功能性便秘的诊断目前采用罗马Ⅲ诊断标准[1]。根据结肠动力学特点和肛门直肠功能，通常将其分为3类：慢传输型便秘、出口梗阻型便秘和混合型便秘。慢传输型便秘是指由于各种原因导致结肠传输减慢、粪便中水分吸收增加等所致的慢性功能性便秘。结肠运输试验是诊断慢传输型便秘的主要方法[2]，但由于结肠运输试验是一种功能性检查方法，在临床应用中如不注意其检查技术及影响因素，很容易引起误诊。本文收集本院2007年3月至2010年12月结肠运输试验36例误诊病例的临床及影像资料并作分析，报告如下。