X线排粪造影与三维高分辨率肛门直肠测压对耻骨直肠肌痉挛的诊断价值比较  

Diagnosis of X-ray Defecography and Three-Dimensional High-Resolution Anorectal Manometry in Puborectalis Spasm:A Comparative Study

作　　者：许燕城 刘启鸿[1,2,3] 吴道清 方文怡[1,2,3] 赵培琳[1,2,3] 何炎琴 高海花[1,2,3] 唐劲松 柯晓 XU Yancheng;LIU Qihong;WU Daoqing;FANG Wenyi;ZHAO Peilin;HE Yanqin;GAO Haihua;TANG Jinsong;KE Xiao(The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China;The Spleen and Stomach Research Institute of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China;Fujian Provincial Clinical Research Center of Traditional Chinese Medicine for the Spleen and Stomach,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院,福建福州350003 [2]福建中医药大学脾胃研究所,福建福州350003 [3]福建省中医脾胃临床医学研究中心,福建福州350003

出　　处：《中国医学影像学杂志》2023年第11期1164-1167,1171,共5页Chinese Journal of Medical Imaging

摘　　要：目的对比X线排粪造影(XRD)与3D高分辨率肛门直肠测压(3D HR-ARM)对耻骨直肠肌痉挛的临床诊断价值。资料与方法回顾性分析2021年1月—2022年6月福建中医药大学附属第二人民医院177例功能性排便障碍患者的XRD和3D HR-ARM检查结果,将符合耻骨直肠肌痉挛诊断的结果进行对比分析。结果177例中XRD诊断耻骨直肠肌痉挛33例(男19例,女14例),3D HR-ARM诊断56例(男34例,女22例),两者均诊断耻骨直肠肌痉挛22例,Kappa值为0.339(P<0.001),XRD与3D HR-ARM对耻骨直肠肌痉挛诊断的一致性一般。3D HR-ARM诊断耻骨直肠肌痉挛的敏感度、特异度及阴性预测值水平较高,分别为66.67%、76.39%、90.91%。结论建议联用XRD与3D HR-ARM诊断耻骨直肠肌痉挛,指导临床治疗,尤其是指导外科手术时须两项检查诊断结果一致。Purpose To compare the clinical value of X-ray defecography(XRD)and three-dimensional high-resolution anorectal manometry(3D HR-ARM)in the diagnosis of functional defecation disorder.Materials and Methods The XRD and 3D HR-ARM data of 177 patients with functional defecation disorder from January 2021 to June 2022 in the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were retrospectively analyzed,and the diagnostic data of puborectalis spasm were further compared.Results Among the 177 patients with functional defecation disorder,33 patients(19 males and 14 females)were diagnosed as puborectalis spasm by XRD,56 patients(34 males and 22 females)were diagnosed as puborectalis spasm by 3D HR-ARM,and a total of 22 patients were consistent in the diagnosis,the Kappa value of consistency was 0.339(P<0.001),the consistency of XRD and 3D HR-ARM in the diagnosis of puborectalis spasm were low.The sensitivity,specificity,positive predictive value and negative predictive value of 3D HR-ARM were high,which were 66.67%,76.39% and 90.91%,respectively.Conclusion It is recommended that the combination of XRD and 3D HR-ARM could be used for the diagnosis of puborectalis spasm,to guide clinical treatment,especially when guiding surgical operations,the two examinations must have consistent diagnostic results.

关 键 词：X线排粪造影 3D高分辨率肛门直肠测压 功能性排便障碍 耻骨直肠肌痉挛 

分 类 号：R442.2[医药卫生—诊断学] R445[医药卫生—临床医学]