儿童直肠检查：肛诊与经腹超声对比
作者：Rosa Burgers, Tom P.V.M. de Jong, Marc A. Benninga 来源：Journal of Urology 日期：2013-03-12
导读
Rectal examination in children: digital versus transabdominal ultrasound
Abstract
Purpose
To investigate two different diagnostic tests to assess the rectal filling state.
Material and methods
Rectal filling state was assessed by transabdominal ultrasound (US) or by digital rectal examination (RE), by two independent investigators, in children with urological problems, prior to a scheduled diagnostic or surgical urological procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed under general anesthesia. The kappa test was used to evaluate agreement between US and RE.
Results
A total of 84 children (54 boys) with a median (p25-p75) age of 9.0 years (6.4- 11) were eligible candidates. A rectal mass was found upon US and RE,in 32% and 41% of all children, respectively, with agreement between the two tests in 82.5%. Cohen’s kappa showed good agreement of 0.62 (95% CI 0.45-0.79) between US and RE. The median (interquartile) diameter of the rectum was 3.3 cm (2.8-3.9) in children with a full rectum and respectively, 2.5 cm (1.8-2.8) and 2.0 cm (1.5-2.2) in patients with a half-filled and empty rectum.
Conclusion
Transabdominal ultrasound is a non-invasive and reliable alternative to assess the rectal filling state and might replace digital RE in the work-up of children with constipation.
http://www.jurology.com/article/S0022-5347(13)03533-7/abstract
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