钡灌肠或结肠镜检查用于缺铁性贫血的检查？
Barium enema or colonoscopy for the investigation of iron deficiency anaemia?
作者信息
Sayer J M, Donnelly M T, McIntyre A S, Barton J R, Grundman M J, Vicary F R, Long R G
机构信息
City Hospital, Nottingham.
出版信息
J R Coll Physicians Lond. 1999 Nov-Dec;33(6):543-8.
OBJECTIVE
To determine whether double contrast barium enema is adequate for excluding carcinoma of the colon in patients with iron deficiency anaemia.
DESIGN
Prospective audit.
SUBJECTS
One hundred and twenty-three patients with iron deficiency anaemia.
INTERVENTION
All patients had upper intestinal (GI) endoscopy, duodenal biopsy and double contrast barium enema. Malignant disease and other GI pathology were treated. Patients with recurrent or persistent anaemia at follow-up were colonoscoped.
OUTCOME MEASURE
Colon cancer missed on barium enema examination but detected on colonoscopic examination.
RESULTS
An identified GI lesion contributing to their anaemia and 11 colon cancers were found in 71% of patients, all identified on barium enema. Two pre-cancerous conditions were missed on barium enema examination. Only 45% colonoscopies inspected the caecum.
CONCLUSION
Double contrast barium enema with sigmoidoscopy is probably sufficient for excluding carcinoma of the colon in iron deficiency anaemia.
目的
确定双重对比钡剂灌肠对排除缺铁性贫血患者的结肠癌是否足够。
设计
前瞻性审计。
研究对象
123例缺铁性贫血患者。
干预措施
所有患者均接受上消化道（GI）内镜检查、十二指肠活检和双重对比钡剂灌肠。对恶性疾病和其他GI病变进行治疗。随访中复发或持续贫血的患者接受结肠镜检查。
观察指标
钡剂灌肠检查遗漏但结肠镜检查发现的结肠癌。
结果
在71%的患者中发现了导致其贫血的已确定的GI病变和11例结肠癌，均在钡剂灌肠检查中发现。钡剂灌肠检查遗漏了2例癌前病变。仅45%的结肠镜检查检查了盲肠。
结论
双重对比钡剂灌肠联合乙状结肠镜检查可能足以排除缺铁性贫血患者的结肠癌。
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