Rodney W M, Randolph J F, Peterson D W
Department of Family Medicine, University of California, Irvine, Orange 92668.
J Clin Gastroenterol. 1988 Jun;10(3):311-4. doi: 10.1097/00004836-198806000-00015.
A randomized prospective study examined the impact of bowel gas introduced by 65-cm flexible sigmoidoscopy (FS) on the ability to perform air-contrast barium enema (ACBE) on the same day. Seventy-five patients at risk for colorectal cancer were randomly assigned to two groups. Of these, 28 patients in each group completed the protocol. The study group received flexible sigmoidoscopy and air-contrast barium enema on the same day, whereas the control group had their air-contrast barium enema on a different day. Bowel gas observed on an abdominal scout film prior to air-contrast barium enema was quantified on a scale of 1 (excessive gas) to 5 (no gas). The cancellation rate for the air-contrast barium enema was measured in each of the groups. The study group had significantly more bowel gas compared with the control group (p = 0.000003). The air-contrast barium enema cancellation rate was also higher in the study group (36%) than in the control group (14%) (p = 0.06). Greater than 60% of the study group patients were successfully examined. Same-day scheduling would reduce the number of bowel preparations required in the evaluation of patients at risk for colorectal cancer. Although retrospective studies have suggested no impact of same-day FS on ACBE quality, radiologists in this study canceled approximately one-third of scheduled patients due to perceived excessive bowel gas.
一项随机前瞻性研究考察了通过65厘米的可弯曲乙状结肠镜检查（FS）引入的肠气对同一天进行气钡双重对比灌肠（ACBE）的影响。75例有患结直肠癌风险的患者被随机分为两组。其中，每组28例患者完成了该方案。研究组在同一天接受可弯曲乙状结肠镜检查和气钡双重对比灌肠，而对照组在不同日期进行气钡双重对比灌肠。在气钡双重对比灌肠前，通过腹部定位片观察到的肠气按1（气体过多）至5（无气体）的量表进行量化。测量每组中气钡双重对比灌肠的取消率。与对照组相比，研究组的肠气明显更多（p = 0.000003）。研究组的气钡双重对比灌肠取消率（36%）也高于对照组（14%）（p = 0.06）。超过60%的研究组患者接受了成功检查。同一天安排检查可减少对有患结直肠癌风险患者进行评估时所需的肠道准备次数。尽管回顾性研究表明同一天的FS对ACBE质量没有影响，但在本研究中，放射科医生因认为肠气过多而取消了约三分之一预定患者的检查。
