使用直肠乙状结肠指数诊断先天性巨结肠症。
Use of the recto-sigmoid index to diagnose Hirschsprung's disease.
作者信息
Garcia R, Arcement C, Hormaza L, Haymon M L, Ward K, Velasco C, Correa H, Congeni J D, Brown R, Tyson P, Udall J, Schmidt-Sommerfeld E
机构信息
Department of Pediatrics, Division of Gastroenterology, State University Health Sciences Center, Baton Rouge, Louisiana, USA.
出版信息
Clin Pediatr (Phila). 2007 Jan;46(1):59-63. doi: 10.1177/0009922806289328.
The recto-sigmoid index on barium enema may aid in the diagnosis of Hirschsprung's disease. However, data on its reliability in different age groups are sparse. The recto-sigmoid index and transitional zone were evaluated blindly in 107 patients with diagnostic rectal suction biopsies. Patients were divided into 3 groups: neonates, infants older than 1 month, and children. The recto-sigmoid index and transitional zone agreed with the histopathologic diagnosis in 79% and 87% of the cases, respectively. Their negative predictive values reached clinical significance in infants and children but not in neonates. Their positive predictive values were not significant in any age group. The recto-sigmoid index identified 4 patients with recto-sigmoid Hirschsprung's disease whose diagnosis was missed by evaluating the transitional zone alone.
钡剂灌肠检查时的直肠乙状结肠指数可能有助于先天性巨结肠的诊断。然而，关于其在不同年龄组可靠性的数据却很稀少。对107例经诊断性直肠吸引活检的患者进行了直肠乙状结肠指数和移行区的盲法评估。患者分为3组：新生儿、1个月以上婴儿和儿童。直肠乙状结肠指数和移行区分别在79%和87%的病例中与组织病理学诊断结果相符。它们的阴性预测值在婴儿和儿童中具有临床意义，但在新生儿中不具有临床意义。它们的阳性预测值在任何年龄组中均无统计学意义。直肠乙状结肠指数发现了4例直肠乙状结肠型先天性巨结肠患者，这些患者仅通过评估移行区被漏诊。
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