Ng D P, Mayberry J F, McIntyre A S, Long R G
Medical Research Centre, City Hospital, Nottingham, UK.
Postgrad Med J. 1991 Oct;67(792):904-6. doi: 10.1136/pgmj.67.792.904.
Rectal (both digital and rigid sigmoidoscopic) examination is an important part of the clinical examination. The aim of this study was to find out the opinions of the patients to this routine examination at the time of referral by their general practitioner and during their first hospital interview. Assessment of the value for the rectal examination was also examined. We questioned 103 patients attending their second out-patient interview through a simple questionnaire. We discovered that patients considered awareness and explanation important: patients preferred to be told of the possibility of rectal examination prior to hospital consultation. Explanation of the method and reason was expected from hospital doctors. Formal consent was expected; informed verbal consent should be sufficient. Where logistically possible, a chaperone should always be present. Rectal examination would have facilitated the diagnosis in 47% of the patients examined. Thus, rectal examination should be performed on all patients where symptoms are referable to the lower gastrointestinal tract and where a possible diagnosis may be made or facilitated.
直肠检查(包括指诊和硬性乙状结肠镜检查)是临床检查的重要组成部分。本研究的目的是了解患者在被全科医生转诊时以及首次医院问诊时对这项常规检查的看法。同时也对直肠检查的价值评估进行了研究。我们通过一份简单的问卷对103名前来进行第二次门诊问诊的患者进行了询问。我们发现患者认为知晓和解释很重要:患者更希望在医院会诊前被告知直肠检查的可能性。期望医院医生对检查方法和原因作出解释。期望获得正式同意;知情的口头同意就足够了。在后勤条件允许的情况下,应始终有一名陪诊人员在场。在47%接受检查的患者中,直肠检查有助于诊断。因此,对于所有有下消化道症状且可能作出诊断或有助于诊断的患者,均应进行直肠检查。