Aldridge M C, Sim A J
Lancet. 1986 Oct 11;2(8511):833-4. doi: 10.1016/s0140-6736(86)92869-2.
Colonoscopy was carried out in 97 patients with persistent large-bowel symptoms in whom double-contrast barium enemas were either normal or showed diverticular disease alone. In 37 the X-ray was normal, but colonoscopy showed 9 polyps and 3 carcinomas. In 60 patients with barium enemas showing diverticular disease alone colonoscopy revealed 13 polyps and 1 carcinoma. Of the 4 carcinomas 1 was Dukes' A, 2 Dukes' B, and 1 Dukes' C. 23 of the 26 patients with a neoplastic lesion at colonoscopy had rectal bleeding, compared with only 40 of the 71 without a lesion. The frequency of neoplasia in those with a normal barium enema was 32%, compared with 23% in those whose X-ray showed diverticular disease. Colonoscopy, rather than double-contrast barium enema, should be the first line of investigation in patients with persistent large-bowel symptoms, especially rectal bleeding.
对97例有持续性大肠症状的患者进行了结肠镜检查，这些患者的双重对比钡灌肠检查结果正常或仅显示憩室病。在37例X线检查正常的患者中，结肠镜检查发现9个息肉和3例癌。在60例钡灌肠仅显示憩室病的患者中，结肠镜检查发现13个息肉和1例癌。4例癌中，1例为Dukes' A期，2例为Dukes' B期，1例为Dukes' C期。结肠镜检查发现有肿瘤性病变的26例患者中有23例有直肠出血，而71例无病变的患者中只有40例有直肠出血。钡灌肠正常者的肿瘤发生率为32%，而X线显示憩室病者的肿瘤发生率为23%。对于有持续性大肠症状，尤其是直肠出血的患者，结肠镜检查而非双重对比钡灌肠检查应作为首选的检查方法。
