先天性巨结肠的诊断:关于常用检测方法准确性对比的前瞻性研究

作     者：De Lorijn F. Reitsma J.B. Voskuijl W.P. 郭战宏 

作者机构：Department of Pediatric Gastroenterology and Nutrition Emma Children' s Hospital AMC/Academic Medical CenterMeibergdreef 9 1105AZ Amsterdam Netherlands Dr. 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第2期

页      面：23-24页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 1010[医学-医学技术（可授医学、理学学位）] 10[医学] 

主　　题：诊断准确性 先天性巨结肠 检测结果 前瞻性研究 肛门直肠测压 肠道功能障碍 显著性差异 敏感性 灌肠造影 阳性结果 

摘      要：Objective: To compare the diagnostic accuracy of contrast enema (CE), anorectal manometry (ARM), and rectal suction biopsy (RSB) for the detection of Hirschsprung’ s disease (HD). Study design: Following a prospective pro-tocol, infants suspected of HD underwent all 3 index tests. Children with positive results on 2 or more index tests or who continued to have severe bowel problems underwent a full thickness biopsy as reference standard. Clinical follow-up was the reference standard in all other children. Results: Between 2000 and 2003, 111 consecutive patients (67 boys; median age, 5.3 months) in whom HD was suspected were enrolled. HD was found in 28 patients. RSB had the highest sensitivity (93% ) and specificity (100% ) rates, but values were not significantly different from CE (sensitivity, 76% ; specificity, 97% ) or from ARM (sensitivity, 83% ; specificity, 93% ). Inconclusive test results occurred in 8 infants with CE, in 15 infants with ARM because of agitation, and in 2 infants with RSB. Conclusion: RSB is the most accurate test for diagnosing HD, and it has the lowest rate of inconclusive test results.