摘要
背景:熟悉功能性肠病(FBDs)的临床特点并了解罗马Ⅲ标准在诊断中的实用性,对其临床诊断具有重要指导意义。目的:比较FBDs与器质性肠病(OBDs)的临床特点,为临床鉴别两种疾病提供依据。方法:对2007年5月8日～10月31日于武汉协和医院消化科行结肠镜检查者进行连续调查,内容包括患者一般情况、下消化道症状、报警症状、内镜检查结果等。FBDs的诊断采用罗马Ⅲ标准并排除报警症状。结果:FBDs为女性多见而OBDs为男性多见(P<0.05)。OBDs组年龄显著高于FBDs组(P<0.01),45岁以上的患者OBDs所占比例逐渐上升。FBDs组病程显著长于OBDs组(P<0.05)。FBDs组腹痛、腹胀、腹部不适、腹泻、便秘、腹泻便秘交替、排便窘迫感、排便不尽感、排便费力症状的发生率显著高于OBDs组(P<0.05)。OBDs组报警症状中以便血最为多见(20.9%)。507例无报警症状且符合FBDs罗马Ⅲ标准的患者中,131例(25.8%)结肠镜检查发现异常,最终诊断为OBDs,腹泻是这部分患者最常见的症状,发生率为58.8%。结论:FBDs与OBDs在性别构成、年龄、病程和临床症状方面均有明显差异。以罗马Ⅲ标准初步诊断FBDs具有临床实用性,但必要时应行结肠镜检查。
Background： Knowing well the clinical characteristics of functional bowel disorders （FBDs） and the practical value of Rome Ⅲ criteria could provide important guidance for the diagnosis of FBDs. Aims： To compare the clinical characteristics between FBDs and organic bowel diseases （OBDs） for providing the rational evidence of differential diagnosis of these two diseases. Methods： A survey was performed on consecutive patients receiving colonoseopy in the Department of Gastroenterology, Wuhan Union Hospital from May 8, 2007 to October 31, 2007. General status, symptoms of lower digestive tract, alarming symptoms and colonoscopic findings, etc. were included in the questionnaire. FBDs was diagnosed when symptoms fulfilled the Rome Ⅲ criteria with absence of alarming symptoms. Results： Compared with the OBDs group, FBDs group was female predominant （P〈0.05）, younger average age （P〈0.01） and longer disease course （P〈 0.05）. In patients above 45 years old, the proportion of OBDs increased gradually. The frequency of abdominal pain, distention, abdominal discomfort, diarrhea, constipation, alternating bowel habit, defecation urgency, incomplete evacuation and difficult defecation was higher in FBDs patients than in OBDs patients （P〈0.05）. Hematochezia was the most common alarming symptom in OBDs group （20.9%）. Among the 507 patients fulfilled the Rome Ⅲ criteria without alarming symptoms, 25.8% （131 patients） were diagnosed as having OBDs according to colonoscopic findings, of whom, diarrhea was a most frequent symptom （58.8%）. Conclusions： The clinical characteristics of FBDs including gender, age, disease course and clinical symptoms are significantly different from those of OBDs. The Rome m criteria are practical and feasible for the preliminary diagnosis of FBDs, however, colonoscopy should be performed when necessary.
出处
《胃肠病学》
2009年第12期738-741,共4页
Chinese Journal of Gastroenterology
关键词
功能性肠病
器质性肠病
罗马Ⅲ标准
体征和症状
问卷调查
诊断
鉴别
Functional Bowel Disorders
Organic Bowel Diseases
Rome Ⅲ Criteria
Signs and Symptoms
Questionnaires
Diagnosis, Differential
