Starreveld J S, Pols M A, Van Wijk H J, Bogaard J W, Poen H, Smout A J
Department of Gastroenterology, University Hospital, Utrecht.
Z Gastroenterol. 1990 Jul;28(7):335-8.
To investigate the value of the plain abdominal radiograph in the assessment of constipation we prospectively studied 30 patients (20 females, 10 males, mean age 48.6 years, range 21-76 years). These patients underwent the following tests: plain abdominal radiograph in supine position, measurement of stool weight (mean of 5 days) and whole gut transit time (20 radioopaque pellets, fluoroscopy of stools). All patients completed a questionnaire regarding their defaecation characteristics (a.o. average defaecation frequency and faecal consistency). The abdominal films were coded and independently scored for the degree of faecal stasis in ascending, transverse, descending colon and rectosigmoid by four gastroenterologists. To each of these parts of the colon a score of 1 (no faeces) to 4 (loaded with faeces) was assigned. The film scores given by the four observers were significantly correlated (p less than 0.001). Significant correlations were found between the radiograph scores and frequency of defaecation, faecal consistency and stool weight. The strength of these correlations were of the same order of magnitude as those between the other subjective and objective defaecation variables. The scores for the left colon (descending colon and rectosigmoid) showed a better correlation with the other defaecation parameters than the scores for the right colon. It is concluded that in the assessment of constipation a simple plain abdominal radiograph is as reliable as measurement of faecal weight or marker transit and can thus be advocated as the first procedure. When an abdominal radiograph is used for this purpose the stasis in the descending and sigmoid colon provides most information.
为了研究腹部平片在便秘评估中的价值，我们对30例患者（20例女性，10例男性，平均年龄48.6岁，范围21 - 76岁）进行了前瞻性研究。这些患者接受了以下检查：仰卧位腹部平片、粪便重量测量（5天的平均值）和全肠道转运时间（20颗不透X线的药丸，粪便透视）。所有患者均完成了一份关于排便特征（包括平均排便频率和粪便稠度等）的问卷。腹部平片进行编码，由四位胃肠病学家独立对升结肠、横结肠、降结肠和直肠乙状结肠的粪便淤滞程度进行评分。结肠的每个部分被赋予1分（无粪便）至4分（充满粪便）的评分。四位观察者给出的平片评分显著相关（p < 0.001）。在平片评分与排便频率、粪便稠度和粪便重量之间发现了显著相关性。这些相关性的强度与其他主观和客观排便变量之间的相关性强度处于同一量级。左半结肠（降结肠和直肠乙状结肠）的评分与其他排便参数的相关性比右半结肠的评分更好。结论是，在便秘评估中，简单的腹部平片与粪便重量测量或标志物转运测量一样可靠，因此可被推荐为首选检查方法。当使用腹部平片进行此目的时，降结肠和乙状结肠的淤滞提供了最多信息。
