Numans Mattijs E
Universitair Medisch Centrum Utrecht, Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A197.
The new guideline on rectal bleeding presents a clear view on what can and should be done in primary care in cases of visible rectal blood loss. However, it does not elaborate on approaches that can be taken to verify that 'rectal bleeding' really is caused by blood loss from the gastrointestinal tract, notably by use of a faecal occult blood test. Nevertheless, the guideline presents practical risk factors that require further diagnostic testing by colonoscopy. More importantly however, plenty of attention is given to the diagnostics and possible interventions that apply to benign causes of rectal bleeding: haemorrhoids, fissures and proctitis. This guideline should stimulate further broadening of proctological skills among general practitioners.
关于直肠出血的新指南清晰阐述了在基层医疗中面对肉眼可见的直肠失血情况时可以且应该采取的措施。然而，该指南并未详细说明可用于核实“直肠出血”确实是由胃肠道失血所致的方法，尤其是使用粪便潜血试验的方法。尽管如此，该指南列出了需要通过结肠镜检查作进一步诊断检测的实际风险因素。但更重要的是，指南对适用于直肠出血良性病因（痔疮、肛裂和直肠炎）的诊断和可能的干预措施给予了充分关注。本指南应促使全科医生进一步拓宽直肠病学技能。
