共查询到17条相似文献,搜索用时 78 毫秒
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夏阳 《中国航天工业医药》1999,1(2):24-26
目的 研究排粪造影对便秘的诊断价值。方法 对51例便秘患行排粪造影检查。结果 直肠前凸32例,盆底痉挛综合征13例,耻骨直肠肌综合征3例,会阴下降35例,直肠粘膜脱垂2例,直肠内套叠2例,直肠外脱垂1例.内脏下垂9例,肠疝1例,骶直分离9例,未见异常2例。结论 排粪造影检查对功能性出口梗阻病变的诊断价值明显优于传统的钡灌肠和内窥镜等检查。 相似文献
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为探讨排粪造影在功能性便秘诊断中的价值。对28例便秘患者先钡灌肠,然后在透视下将钡剂排出,结果发现功能性出口梗阻原因很多,所以排粪造影对诊断功能性便秘起到很大作用。 相似文献
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目的评价直肠排粪造影在便秘原因诊断中的意义。方法56例临床怀疑由于肛肠疾病引起的便秘患者(女51例,男5例,年龄33~72岁,平均41岁)均在经肛门——直肠灌注对比剂为160%(W/V)的硫酸钡250mL后接受了直肠排粪造影。结果在56例便秘患者中,直肠前突见于42例。耻骨直肠肌肥厚4例,直肠前壁黏膜脱垂3例,直肠内套叠3例,乙状结肠疝2例,直肠息肉1例,以及经病理证实的直肠癌1例。结论直肠排粪造粪造影在便秘的病因学诊断中具有高度准确性。 相似文献
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目的 探讨动态采集法排粪造影对直肠内脱垂(internal rectal prolapse,IRP)的诊断价值.资料与方法 回顾性分析469例出口梗阻性便秘患者的常规和动态排粪造影表现,统计IRP的显示率.采用χ2检验比较两种方法的显示率.结果 动态采集法发现IRP 392例,显示率94%(392/417);常规法发现IRP 54例,显示率56.25%(54/96);两种方法差异有统计学意义(χ2=97.94,P<0.01).结论 动态排粪造影能提高IRP的显示率,可准确显示病变程度,为临床提供更可靠的治疗依据,可作为出口梗阻性便秘检查的首选. 相似文献
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Reiner CS Tutuian R Solopova AE Pohl D Marincek B Weishaupt D 《The British journal of radiology》2011,84(998):136-144
Objectives
We describe the spectrum of findings and the diagnostic value of MR defecography in patients referred with suspicion of dyssynergic defecation.Methods
48 patients (34 females, 14 males; mean age 48 years) with constipation and clinically suspected dyssynergic defecation underwent MR defecography. Patients were divided into patients with dyssynergic defecation (n = 18) and constipated patients without dyssynergic defecation (control group, n = 30). MRIs were analysed for evacuation ability, time to initiate evacuation, time of evacuation, changes in the anorectal angle (ARA-change), presence of paradoxical sphincter contraction and presence of additional pelvic floor abnormalities. Sensitivity, specificity, positive and negative predictive values and accuracy for the diagnosis of dyssynergic defecation were calculated.Results
The most frequent finding was impaired evacuation, which was seen in 100% of patients with dyssynergic defecation and in 83% of the control group, yielding a sensitivity for MR defecography for the diagnosis of dyssynergic defecation of 100% (95% confidence interval (CI) 97–100%), but a specificity of only 23% (95% CI 7–40%). A lower sensitivity (50%; 95% CI 24–76%) and a high specificity (97%; 95% CI 89–100%) were seen with abnormal ARA-change. The sensitivity of paradoxical sphincter contraction was relatively high (83%; 95% CI 63–100%). A combined analysis of abnormal ARA-change and paradoxical sphincter contraction allowed for the detection of 94% (95% CI 81–100%) of the patients with dyssynergic defecation.Conclusion
MR defecography detects functional and structural abnormal findings in patients with clinically suspected dyssynergic defecation. Impaired evacuation is seen in patients with functional constipation owing to other pelvic floor abnormalities than dyssynergic defecation.Dyssynergic defecation, which produces functional outlet obstruction during defecation, is one of the causes of chronic constipation. Dyssynergic defecation is a functional disorder characterised by either paradoxical contraction, an inability to relax the anal sphincter and/or puborectalis muscle, or impaired abdominal and rectal pushing forces. In the literature, many other terms such as anismus [1], dyskinetic puborectalis muscle [2], non-relaxing puborectalis syndrome [3], spastic pelvic floor syndrome [4, 5] and pelvic floor dyssynergia [6] have been used. An expert group (Rome III) [7] recently proposed the term “dyssynergic defecation” to appropriately describe the failure of co-ordination or dyssynergia of the abdominal and pelvic floor muscles involved in defecation. Different physiological tests can be used to investigate this functional disorder, including the balloon expulsion test, electromyography (EMG) of the puborectalis muscle and anorectal manometry. Defecography can be performed to rule out structural rectal abnormalities and provide an estimate of the degree of rectal emptying. As false-positive and false-negative results are common with these different tests, none can be used by itself as a gold standard for identifying patients with dyssynergic defecation.Most authorities recommend using a combination of diagnostic tests and clinical history. The Rome III expert group defined the criteria for the diagnosis of dyssynergic defecation based on clinical history, anorectal manometry, balloon expulsion test, EMG and conventional defecography (evacuation proctography) [7]. Functional imaging with conventional defecography is considered to be a useful adjunct in establishing the diagnosis of dyssynergic defecation. Delayed initiation of evacuation and impaired evacuation in particular, as seen on conventional defecography, are highly predicitive for the presence of dyssynergic defecation [8, 9]. Different structural imaging findings in conventional defecography have been described in patients with dyssynergic defecation; however, the usefulness of these findings is discussed controversially [8, 10, 11].The experience with MR defecography, which has shown to be a valuable alternative to evacuation proctography [12–15], is limited in dyssynergic defecation patients. There is only one study which has focused on the MR defecography findings in a study setting in patients with dyssynergic defecation [16]. Hence, the purpose of this study was to describe the spectrum of findings in MR defecography in patients referred with the suspicion of dyssynergic defecation and to assess the value of MR defecography in establishing this diagnosis. For the latter, the patients with dyssynergic defecation were compared with a group of constipated patients without dyssynergic defecation. 相似文献12.
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后盆腔障碍疾病是以肛直肠解剖和功能异常为主的一类盆底功能障碍性疾病,伴有便秘、便失禁等临床症状。MR排便造影是一种动态MR成像方法,可对后盆腔结构形态和运动功能异常情况直观显示,能够鉴别后盆腔障碍性疾病的类型并认识其发病原因,如直肠膨出、肠疝、盆腔器官脱垂和直肠套叠、脱垂等,同时对便失禁早期的肛直肠形态学和功能学异常改变的诊断有重要提示价值。 相似文献
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Anorectal function in patients with defecation disorders and asymptomatic subjects: evaluation with defecography 总被引:13,自引:0,他引:13
R Goei 《Radiology》1990,174(1):121-123
A controlled radiologic study of anorectal function was performed with the use of defecography in 19 patients with constipation and 13 with incontinence. All patients were age and sex matched to control subjects who were referred for barium enema study and who had no defecation disorder. There were no statistically significant differences between either patient group and the control group in anorectal angle and excursion of the anorectal junction. In the 32 patients and 155 consecutive patients referred for defecography because of a variety of defecation disturbances, approximately twice as many rectal wall abnormalities were seen compared with findings in the control group. These findings included intussusception, rectal prolapse, rectocele, mucosal prolapse, spastic pelvic floor, descending perineum syndrome, and solitary rectal ulcer syndrome. In conclusion, the main role of defecography is to document rectal wall changes during defecation straining as possible causes of evacuation difficulties. Clinical symptoms should also be taken into account when treatment is contemplated. 相似文献
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排粪造影对会阴下降的诊断价值 总被引:3,自引:1,他引:2
会阴下降是便秘常见原因之一,术前常规影像诊断较为困难。排粪造影是当患者“排粪”时对其肛管直肠作全程动静态结合的功能检查方法,是诊断会阴下降较理想的检查方法之一。本文回顾性分析179例经排粪造影明确诊断为会阴下降病例的影像资料,探讨排粪造影检查对会阴下降的诊断价值。 相似文献
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目的探讨排粪造影在诊断与治疗功能性出口梗阻性便秘中的应用。方法对186例排便障碍者进行排粪造影检查与治疗。结果 7例X线无异常,179例有异常X线表现。其中直肠前突113例,直肠黏膜脱垂、内套叠92例,会阴下降64例,盆底痉挛综合征11例,耻骨直肠肌综合征7例,内脏下垂7例,乙状结肠疝3例。其中多种异常表现并存69例。结论排粪造影对功能性出口梗阻性便秘的诊断与治疗具有重要价值。 相似文献
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便秘是临床常见症状,病因复杂繁多,中医学认为便秘与脾胃和肾的关系密切,属大肠传导功能异常所致,便秘易引起多种疾病,如肛肠功能性疾病、胃肠神经功能紊乱、结肠癌、诱发心脑血管意外、妇科疾病等。中医辨证施治,将便秘分为:气秘、热秘、冷秘;分别由气虚、血虚、阴虚所致。在临床,一般患者经过生活调理和药物治疗,便秘症状都会得到改善.因此,一旦患有便秘,要立即找出原因,及时治疗,以免后患。 相似文献