探讨改良结肠运输试验对慢性便秘鉴别诊断及指导治疗中的价值。

选取2013年1月至2015年6月，江苏省苏北人民医院胃肠外科便秘专科门诊诊治的慢性便秘患者52例，对52例不同程度排便困难患者和10例健康对照者进行改良结肠运输试验，即在禁食促排便药物72 h后行上消化道钡餐检查，6 h和72 h后再分别拍摄腹部平片，观察钡剂在肠道残留情况，根据检查结果分类并予以相关治疗。

所有患者未见胃肠道器质性病变。7 h后，10例健康对照者肠道内无钡剂残留，39例患者钡剂残留在结肠（诊断为慢传输型），5例患者钡剂残留在直肠（诊断为出口梗阻型），而8例患者钡剂残留在结直肠内（诊断为混合型）。所有患者予以促结肠动力药物普芦卡必利（2 mg/d）±乳果糖（30 mg/d）治疗，其中1例慢传输型患者、1例出口梗阻型患者和8例混合型患者无效，予以施行腹腔镜下金陵术治愈。

改良结肠运输试验对慢性便秘的诊断具有重要价值，有助于不同便秘类型的鉴别及针对性治疗。

To explore the value of modified colonic transit test in differential diagnosis and treatment of chronic constipation.

52 patients with chronic constipation at Subei People′s Hospital were choosen between January 2013 and June 2015. Modified colonic transit test was performed in 52 patients with different degrees of discharge difficulty and 10 healthy controls. The procedure of modified colonic transit test was as follows: after 72 hours of abstaining from all the laxatives, the patients were performed upper gastrointestinal barium meal examination, and the plain abdominal radiograph were taken 6 hours and 72 hours later respectively, which were used to observe the residues of barium in the colon and rectum, and then the related treatments were performed.

All patients had no gastrointestinal lesions. After 72 hours, 10 healthy controls had no barium residue, and 39 patients had barium residue in colon (diagnosed as a slow transmission type of constipation), and 5 patients had barium residue in the rectum (diagnosis as an outlet obstruction type of constipation), and 8 patients had barium residue in colon and rectum (diagnosis as a mixed type of constipation). All patients were treated with prucalopride (2 mg/d) with or without lactulose (30 mg/d), in which 1 patients with slow transmission type, and 1 patients with outlet obstruction and 8 patients with mixed type of constipation were ineffective and were cured by laparoscopic Jinling procedure.

Modified colonic transit test was useful for the diagnostic of chronic constipation, which is helpful for the differential diagnosis and treatment of different types of constipation.