Wafula J M
Brook General Hospital, London.
Br J Gen Pract. 1992 Aug;42(361):330-2.
Although the double contrast barium enema is the standard radiological examination of the colon, it is not universally available to patients referred by their general practitioners. A retrospective survey of all double contrast barium enemas carried out over a two year period in one health district was undertaken to determine the diagnostic yield of pathological findings for patients referred by general practitioners and hospital outpatient departments and for patients who had rigid sigmoidoscopy prior to the enema and those who did not. A total of 530 patients were studied. The diagnostic yield for the hospital outpatients was 41.6% and in the general practitioner group 35.6%. In the patients who had rigid sigmoidoscopy the yield was 42.7% compared with 32.6% in those who had no prior sigmoidoscopy. It is concluded that the withdrawal of direct access for barium enemas to general practitioner patients in this district because of a low diagnostic yield cannot be justified. The lower diagnostic yield in the patients who did not have sigmoidoscopy supports the policy of requiring this examination prior to all barium enemas.
尽管双重对比钡灌肠是结肠的标准放射学检查，但对于全科医生转诊的患者来说，并非普遍都能进行该项检查。对某一健康区在两年时间内进行的所有双重对比钡灌肠检查进行了一项回顾性调查，以确定全科医生和医院门诊部转诊患者以及灌肠前进行过硬性乙状结肠镜检查的患者和未进行过该检查的患者的病理诊断率。总共研究了530名患者。医院门诊患者的诊断率为41.6%，全科医生组为35.6%。进行过硬性乙状结肠镜检查的患者诊断率为42.7%，而未进行过乙状结肠镜检查的患者诊断率为32.6%。得出的结论是，因诊断率低而取消该地区全科医生转诊患者直接进行钡灌肠检查的做法是不合理的。未进行乙状结肠镜检查的患者诊断率较低，这支持了在所有钡灌肠检查前都要求进行该项检查的政策。
