Southwell Bridget R, Clarke Melanie C C, Sutcliffe Jonathan, Hutson John M
Surgical Research Group, Gut Motility Laboratory, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia.
Pediatr Surg Int. 2009 Jul;25(7):559-72. doi: 10.1007/s00383-009-2387-x. Epub 2009 Jun 2.
The sitz or plastic marker study for colonic transit has been around for many years. It is applicable where an X-ray machine exists, is widely used and is accepted as the gold standard for diagnosing constipation. Recently, radiopharmaceutical methods have been developed. The theme of this review is their possible roles in the assessment of paediatric bowel motility disorders in patients presenting to paediatric surgeons. This review presents data on total and segmental transit in normal adults and children and comparing the two techniques in adults. Reliability and reproducibility are presented. Normative data for colonic transit in adults and children are discussed and parameters for assessing abnormal transit are reviewed. Normal colonic transit takes 20-56 h. Plastic marker studies are more readily accessible, but the assessment may be misleading with current methods. Plastic markers show faster transit than scintigraphy. It is difficult to compare the two techniques because methods of reporting are different. Using scintigraphy, repeatability is good. Separation of normal from slow transit in the ascending colon is apparent at 24 and 48 h, but the determination of transit through the distal colon/rectum in adults may require studies of more than 7 days. In conclusion, plastic marker studies and scintigraphy show similar transit rates in young adults and children. However, scintigraphy has advantages of allowing transit through the stomach and small intestine to be measured and has proved useful in the diagnostic workup of children with intractable constipation.
用于结肠运输的坐式或塑料标记物研究已经存在多年。它适用于有X光机的地方，被广泛使用，并被公认为诊断便秘的金标准。最近，放射性药物方法得到了发展。本综述的主题是它们在评估儿科外科就诊患者的小儿肠道运动障碍中可能发挥的作用。本综述介绍了正常成人和儿童的全结肠及分段运输数据，并比较了成人的两种技术。还介绍了可靠性和可重复性。讨论了成人和儿童结肠运输的标准数据，并回顾了评估异常运输的参数。正常结肠运输时间为20 - 56小时。塑料标记物研究更容易进行，但目前的方法评估可能会产生误导。塑料标记物显示的运输速度比闪烁扫描快。由于报告方法不同，很难比较这两种技术。使用闪烁扫描，重复性很好。在24小时和48小时时，升结肠中正常运输与缓慢运输的分离很明显，但确定成人远端结肠/直肠的运输可能需要超过7天的研究。总之，塑料标记物研究和闪烁扫描在年轻人和儿童中显示出相似的运输速度。然而，闪烁扫描具有能够测量通过胃和小肠的运输的优点，并且已被证明在难治性便秘儿童的诊断检查中很有用。
