便血患者指诊和镜检诊断结果比较

Comparison of the Diagnostic Results between Digital Examination and Anoscopy for Patients with Hematochezia

为比较便血患者肛门直肠指诊与肛门镜检查结果，对200例便血患者同时进行指诊和镜检。结果显示，血迹：指诊检出率34％（68／200），镜检89％（178／200）（P〈0．005）；内痔或混合痔的内痔部分：指诊检出率11．8％（18／152），镜检100％（152／152）（P〈0．005）；肛裂：指诊检出率100％（52／52），镜检100％（52／52）；直肠肿瘤或息肉：指诊检出率100％（7／7），镜检28．6％（2／7）。结果表明，镜检对血迹检出率明显高于指诊检出率，对内痔或混合痔的内痔部分的检出率也明显高于指诊检出率，对质地偏中上的肿物如直肠肿瘤或息肉，指诊检出率优于镜检。所以对便血的患者不要仅满足指诊的结果，必须结合镜检，各取所长，以防遗漏。

Two hundreds patients with hematochezia received concurrently digital examination and anoscopy. As results,the detectable rate of blood stain of digital examination was 34% （68/200）, while that of anoscopy was 89%（178/200, P〈0. 005）;the detectable rate of internal hemorrhoid or that internal hemorrhoid part of mixed hemorrhoid of digital examination was 11.8 % （18/152）, while that of anoscopy was 100%（152/152, P〈0. 005）;the detectable rate of anal fissure of digital examination was 100%（52/52）, while that of anoscopy was also 100%（52/52）;and the detectable rate of rectal tumor or polyp of digital examination was 100%（7/7）,while that of anoscopy was 28.6%（2/7）. It is suggested that digital examination and anoscopy have their respective stronger points in the examination of patients with hematochezia, and that both diagnostic approaches are better provided for patients with hematochezia.