无痛肠镜与常规肠镜检查的前瞻性对照研究  

Sedated versus conventional colonoscopy： a prospective study on patient acceptability and satisfaction

作　　者：万一[1] 吴嘉钏 刘倩[1] 孟晓弘 季明昉[1] 徐贝黎[1] 邱冬梅[1] 蒋慧[1] 戴明舟 杜重临 许斌[1] 王蕾[1] 程时丹[1] 钟捷[1] 龚彪[1] 夏璐[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化内镜中心,上海200025

出　　处：《中华消化内镜杂志》2014年第9期494-498,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨无痛肠镜和常规肠镜检查在临床工作中的选择。方法362例自愿接受无痛肠镜检查患者（无痛肠镜组）和323例自愿接受常规肠镜检查患者（常规肠镜组）纳入对照研究，均于检查结束后完成问卷调查，统计分析2组检查完成情况、操作时间、检查费用、不适反应发生情况以及问卷调查结果。结果无痛肠镜组和常规肠镜组检查完成率分别为98．9％（358／362）和89．8％（290／323）（P=0．337），操作时间分别为（5．60±3．25）min和（7．71±5．70）min（P〈0．001），平均检查费用分别为人民币886．54元／人和386．00元／人（P〈0．001），操作相关不适反应总发生率分别为13．3％（48／362）与83．6％（270／323）（P〈0．001），患者满意度评分分别为4（3-4）分和3（2-3）分（P〈0．001），操作者满意度评分分别为4（34）和4（4-4）分（P〈0．001）。无痛肠镜组和常规肠镜组愿意再次接受相同检查方式检查的患者数分别为354例（97．79％）和225例（69．66％）（P〈0．001），常规肠镜组愿意再次接受常规肠镜检查的相关因素分析结果显示男性患者（P=0．035）、无腹部手术史者（P〈0．001）、检查过程中未出现腹痛者（P=0．015）更愿意再次接受常规肠镜检查。结论常规肠镜检查虽然耗时较长，但可避免麻醉风险，且检查所需费用较低，仍是目前国内结直肠疾病检查不可欠缺的重要方法。内镜医师在选择肠镜检查方式时，不仅要考虑患者术中耐受，更要根据患者实际情况严格把握适应证，在充分利用现有医疗资源的前提下使患者得到及时的诊治。Objective To compare the clinical choosing principles of sedated colonoscopy with con- ventional colonoscopy. Methods Outpatients who were willing to accept colonoscopy with or without seda- tion were prospectively recruited, which were assigned to sedated co]onoscopy group （ n = 362 ） and conven- tional colonoscopy group （ n = 323 ）. All patients and endoscopists were asked to answer a self-administered questionnaire. The colonoscopy completion, operation time, procedure-related discomfort, and questionnaire results of the two groups were compared and statistically analyzed. Results The completion rate was 98. 9% in the sedated colonoscopy group （358/362） and 89. 8% in the conventional colonoscopy group （290/323） （P =0. 337 ）. The operation time of sedated and conventional group were （5.60±3.25 ） minutes and （7. 71±5.70） minutes respectively （P 〈 0. 001 ）. And the average cost was C NY 886. 54 per patient in se- dated group and CNY 386. 00 per patient in the conventional group. Patient satisfaction score of conventional group and sedated group were 4 （3-4） and 3 （2-3） points （P 〈 0. 001 ）, while endoscopist satisfaction score was 4（3-4） and 4（4-4） （P 〈0. 001 ）. A total of 354 patients（97. 79% ） in the sedated group and 225 pa- tients （69.66%） in the conventional group showed willingness to repeat the identical colonoscopy （P 〈O. 001 ）. Patients who were male （P =0. 035）, having no past abdominal operations（P 〈0. 001 ）, or no ab- dominal pain during eolonoseopy （ P = O. 015 ） in the conventional group preferred to repeat conventional eolonoseopy. Conclusion Although the examination time of conventional eolonoseopy is longer than sedated eolonoscopy, it could reduce anesthesia risk and the eost. Conventional colonoscopy remains an irreplaceable examination of colorectal diseases in developing countries. Physicians should not only focus on patients＇ com- fort during endoscopy, but also help patients make a deeision based o

关 键 词：结肠镜检查 耐受性 患者满意度 

分 类 号：R574[医药卫生—消化系统]