摘要
目的:分别按照Rome Ⅱ和传统Iowa标准,对同一组患者进行临床诊断,分别求得儿童胃肠功能紊乱发病率并加以比较分析。方法:病历资料记录了患者排便次数与大便失禁次数。采集患者的标准病史,并对患者进行体格检查,包括直肠检查。分别采用上述两个标准对患者作出临床诊断,并比较两种标准求得的患病率。结果:共有198例连续性病例被纳入本次试验,患者年龄从0.66岁到15.76岁,其中131例为男性患儿。按照Rome Ⅱ标准,分别有64%、18%和21%的患儿,符合功能性便秘、功能性大便潴留和功能性无潴留性粪便失禁的临床诊断标准。使用传统的Iowa标准,有74%和18%的患儿分别符合儿童型便秘和单纯性大便失禁的临床诊断标准;儿童型便秘患者中,有16%的患儿不符合Rome Ⅱ的便秘诊断标准。功能性无潴留性大便失禁和单纯性大便失禁,其分别按照上述两个标准所得到的诊断结果之间,具有较高的一致性。
Objectives To evaluate the prevalence of pediatric functional gastrointestinal disorders with the use of the Rome Ⅱ criteria and to compare these data with the classic Iowa criteria. Study design Patients recorded defecation and encopresis frequency. A standard history was taken and a physical examination including a rectal examination was done. The prevalence of both criteria was assessed and compared. Results One hundred ninety-eight consecutive patients (age, 0. 66 to 15. 76 years; 131 male subjects) were included. According to the Rome Ⅱ criteria, 64%, 18%, and 21% of patients fulfilled the criteria for functional constipation, functional fecal retention, and functional nonretentive fecal soiling, respectively. Using the classic criteria, 74% and 18% of patients fulfilled the criteria for pediatric constipation and solitary encopresis, respectively; 16% of the patients fulfilling the pediatric constipation criteria were not recognized by the Rome Ⅱ constipation criteria. Fair agreement was found between functional nonretentive fecal soiling and solitary encopresis. Encopresis was present in 79% of constipated children. Conclusions The Rome criteria are restrictive and exclude several children with constipation. We recommend including encopresis and rectal digital examination and excluding arbitrary age limits and retentive behavior in the revision of the Rome criteria.
