钡剂结肠造影检查对便秘型肠易激综合征的诊断价值  

Diagnostic value of X-ray barium meal contrast examination in constipation-predominant irritable bowel syndrome

作　　者：廖常奎[1] 刘敬涛[2] 康敏[3] 

机构地区：[1]四川省妇女儿童医院内科,四川省成都市610041 [2]四川省妇女儿童医院信息科,四川省成都市610041 [3]四川省妇女儿童医院放射科,四川省成都市610041

出　　处：《世界华人消化杂志》2017年第10期934-939,共6页World Chinese Journal of Digestology

摘　　要：目的分析探讨结肠X线钡剂造影检查对诊断便秘型肠易激综合征(constipation-predominant irritable bowel syndrome,C-IBS)的价值和临床意义.方法纳入2014-10/2016-09来四川省妇女儿童医院就诊的574例女性便秘患者,选择其中符合C-IBS(165例)和功能性便秘(functional constipation,FC)(80例)诊断条件的共245例患者做结肠X线钡剂造影检查,根据结肠钡剂造影显示的结构、形态和功能变化表现判断患者的腹痛、腹部不适、便秘、排便困难等临床症状和病情程度.结果两组患者横结肠均呈现γ、ω和m型、肠腔扩张和乙状结肠冗长、迂曲等形态结构变化,C-IBS患者的结肠形态变化与腹痛发生的解剖部位较为一致;两组患者的乙状结肠冗长、迂曲形态表现均与Bristol分级的粪质干硬、排便次数减少、排便困难等排便异常现象有关(P>0.05);结肠蠕动迟缓、僵直、肠腔扩张、肠壁花瓣消失等变化与C-IBS腹痛分级和排便异常有关(P<0.05);肠壁花辦消失反映了结肠蠕动迟缓、僵直、柔韧度下降、肠腔扩张等情况,FC缺乏典型的肠道易激惹征像.结论 X线钡剂造影检查对判断结直肠形态结构和功能紊乱具有重要临床价值,对IBS-C患者是值得推荐的一种检查方法.AIM To assess the value of X-ray barium meal contrast examination in the diagnosis of constipationpredominant irritable bowel syndrome（C-IBS）.METHODS From October 2014 to September 2016,574 women with constipation visited our hospital,of which 165 with C-IBS and 80 with functional constipation（FC） were included in this study and underwent X-ray barium meal contrast examination.According to the structure,morphology and functional changes of the colon as revealed by X-ray barium meal contrast examination,clinical symptoms such as abdominal pain,abdominal discomfort,constipation,and difficulty in defecation as well as disease severity were assessed.RESULTS The transverse colon of patients in both groups exhibited structural or morphological changes such as γ,ω and m types,intestinal cavity expansion,redundant or tortuous sigmoid colon.The anatomical location of abdominal pain was consistent with structural or morphological changes in the colon of C-IBS patients.The redundant or tortuous sigmoid colon in both groups was significantly associated with hard stools,reduced defecation frequency,and difficulty in defecation described in the Bristol Stool Form Scale（P〉0.05）.Slow colonic peristalsis,colon rigidity,intestinal cavity expansion and colonic wall changes were significantly associated with C-IBS abdominal pain grade and bowel abnormalities（P〈0.05）.Colonic wall changes often suggested slow colonic peristalsis,colonic rigidity,decreased colonic flexibility and intestinal cavity expansion.FC patients lacked typical intestinal irritable symptoms.CONCLUSION X-ray barium contrast examination is of high value in evaluating colorectal morphology,structure and dysfunction and can be used for diagnosing IBS-C.

关 键 词：便秘型肠易激综合征 功能性便秘 结肠X线钡剂造影 结肠结构形态 结肠运动功能障碍 

分 类 号：R574.62[医药卫生—消化系统]