直肠阴道检查是一种用于补充骨盆检查的妇科检查。在直肠阴道检查中，医生或其他医疗保健提供者将一根手指放在阴道中，另一根放在直肠中以评估直肠阴道隔膜。检查员将寻找任何可能表明癌症或其他疾病的疤痕或肿块。通常，进行直肠阴道检查以评估骨盆疼痛，直肠症状或骨盆肿块。它还可以为粪便潜血试验提供样本。[1]
用作无症状女性的筛查试验
尽管手术室的控制情况包括全身麻醉，膀胱空洞和理想的患者定位，但直肠阴道检查仍有明显的局限性。正如所怀疑的那样，由于疾病流行率低，直肠检查的特异性很高。然而，直肠阴道检查的敏感性非常低，限制了其作为筛选试验的能力。 [2]
骨盆检查可以包括以下任何组分，单独或组合：外生殖器的评估，内窥镜检查，双手触诊和直肠阴道检查。 USPSTF发现骨盆检查准确性的证据不足以检测一系列妇科疾病。 [3]
虽然直肠指检（DRE）常用于在办公室环境中获取FOBT（粪便潜血试验）的粪便样本，但这不是一种筛查结直肠癌的方法，不推荐。[ 4] [5] [6]由于对晚期肿瘤和结直肠癌的低敏感性，在直肠指检（DRE）后进行的单一基于办公室的FOBT（粪便潜血试验）不是一个合适的筛查。[7]发表在“内科医学杂志”上的一篇论文指出，“虽然FOBT做得恰当（带回家并根据说明使用）是一个重要的筛选选择，但办公室FOBT可能比没有筛选更糟糕，因为它错过了95％的晚期肿瘤病例，给许多患者一种虚假的安慰感。“[8]
参考
Hoffman, Barbara L.; Schorge, John O.; Schaffer, Joseph I.; Halvorson, Lisa M.; Bradshaw, Karen D.; Cunningham, F. Gary (2012). "Well Woman Care". Williams Gynecology (2nd ed.). McGraw Hill Medical. p. 6. ISBN 978-0-07-171672-7.
Milad, M. P.; Padilla, L. A.; Dragisic, K. G. (2003-08-01). "The accuracy of the rectovaginal examination in detecting cul‐de‐sac disease in patients under general anaesthesia". Human Reproduction. 18 (8): 1712–1715. doi:10.1093/humrep/deg350. ISSN 0268-1161.
Tseng, Chien-Wen; Siu, Albert L.; Simon, Melissa; Silverstein, Michael; Phipps, Maureen G.; Phillips, William R.; Mangione, Carol M.; Landefeld, C. Seth; Kurth, Ann E. (2017-03-07). "Screening for Gynecologic Conditions With Pelvic Examination: US Preventive Services Task Force Recommendation Statement". JAMA. 317 (9): 947–953. doi:10.1001/jama.2017.0807. ISSN 0098-7484.
Wender, R. C. (2006). "Colorectal cancer screening: Don't just do it, do it right". American Family Physician. 73 (10): 1707–8. PMID 16734049.
Ashraf, Imran; Paracha, Shafaq R.; Arif, Murtaza; Choudhary, Abhishek; Matteson, Michelle L.; Clark, Robert E.; Godfrey, Jonathan D.; Hammad, Hazem T.; Bechtold, Matthew L. (2012). "Digital Rectal Examination Versus Spontaneous Passage of Stool for Fecal Occult Blood Testing". Southern Medical Journal. 105 (7): 357–361. doi:10.1097/SMJ.0b013e31825bfdc5. PMID 22766663.
Nadel, Marion R.; Shapiro, Jean A.; Klabunde, Carrie N.; Seeff, Laura C.; Uhler, Robert; Smith, Robert A.; Ransohoff, David F. (2005). "A National Survey of Primary Care Physicians' Methods for Screening for Fecal Occult Blood". Annals of Internal Medicine. 142 (2): 86–94. doi:10.7326/0003-4819-142-2-200501180-00007. PMID 15657156.
Collins, Judith F.; Lieberman, David A.; Durbin, Theodore E.; Weiss, David G.; Veterans Affairs Cooperative Study #380 Group (2005). "Accuracy of Screening for Fecal Occult Blood on a Single Stool Sample Obtained by Digital Rectal Examination: A Comparison with Recommended Sampling Practice". Annals of Internal Medicine. 142 (2): 81–5. doi:10.7326/0003-4819-142-2-200501180-00006. PMID 15657155.
Nadel, Marion R.; Berkowitz, Zahava; Klabunde, Carrie N.; Smith, Robert A.; Coughlin, Steven S.; White, Mary C. (2010). "Fecal Occult Blood Testing Beliefs and Practices of U.S. Primary Care Physicians: Serious Deviations from Evidence-Based Recommendations". Journal of General Internal Medicine. 25 (8): 833–839. doi:10.1007/s11606-010-1328-7. PMC 2896587. PMID 20383599. |
