前置短透明帽在无痛单人结肠镜检查中的临床应用价值  

Clinical Application of Short Transparent Hook in Colonoscopy in Single-man Method Colonoscopy Under Sedation

作　　者：高小毛[1] 孙天燕[1] 刘杰[1] 胡兆元[1] 孙乐 张克宁[1] 刘亚文 吴作艳[1] Gao Xiaomao;Sun Tianyan;Liu Jie(Department of Gastroenterology,Beijing No.6 Hospital,Beijing 100007,China)

机构地区：[1]北京市第六医院消化内科,100007

出　　处：《医学研究杂志》2020年第8期124-128,共5页Journal of Medical Research

基　　金：北京市东城区卫生和计划生育委员会医联体学科建设项目(20181116)。

摘　　要：目的探讨使用前置短透明帽对无痛单人结肠镜检查进镜时间及结直肠息肉检出率的影响。方法选取来自北京市第六医院内镜中心行无痛结肠镜检查且符合纳入标准的400例患者,随机分为短透明帽组(200例)和对照组(200例),由一名肠镜技术中级医生完成无痛单人结肠镜检查,比较两组患者的一般资料、盲肠插入时间、退镜时间、息肉检出数目、息肉部位、息肉直径及形态等c结果短透明帽组盲肠插入时间短于对照组(6.17±2.57min vs 6.84±2.64min,P=0.015),两组盲肠插入成功率和退镜时间比较,差异无统计学意义(P>0.05)。两组共检出息肉患者173例,检出息肉338个,短透明帽组检出息肉患者97例,息肉192个,对照组检出息肉患者76例,息肉146个。患者总体息肉检出率47.5%,短透明帽组息肉检出率高于对照组(52.7%vs 42.2%,P=0.045)o短透明帽组直径mm的息肉检出率高于对照组(55.7%vs 44.5%,P=0.041)。两组检出的息肉形态比较,差异无统计学意义(P>0.05)。透明帽组在盲肠、升结肠、乙状结肠部位比对照组检出更多的息肉(P<0.05)。两组均未发生出血、穿孔等并发症。结论前置短透明帽辅助结肠镜检查可有效缩短进无痛单人结肠镜检查的镜时间,提高结直肠息肉的检出率,特别是提高直径W5mm的息肉检出率。Objective To analyze the effect of colonoscopy assisted with a short transparent hook on operation time and detection rate of polyp in single-man method colonoscopy under sedation.Methods A toltal of 400 patients who enderwent colonoscopic examinations at the digestive endoscopy center of Beijing No.6 Hospital were randomized to transparent hood assisted colonoscopy group(TH AC)(n=200)and regular control group(n=200).All colonsocopies were performed by one middle-level endoscopist under anesthesia.Baseline characteristics,cecal intubation time,withdrawal time,number of polyps,detection rate of polyps,location and size between two groups were compared.Results Compared with regular control group,cecal intubation time was significantly shorter in BH AC group(6.17±2.57min vs 6.84±2.64min,P=0.015).No significant differences in withdrawal time and rate of cecal intubation were found between two groups(P>0.05).A total of 338 polyps were detected in 173 patients,192 polyps in 97 patients of TH AC group,146 polyps in 76 patients of regular control group.Total polyp detection rate was 47.5%.Detection rates of polyps was significantly higher in THAC group than in regular control group(52.7%vs 42.2%,P=0.045).The detection rate of diminutive polyps(W5mm)tended to be higher in the TH AC group than in the regular control group(55.7%vs 44.5%,P=0.041).There was no difference in the morphology of polyps between the two groups(P>0.05).More polyps in cecum,sacends colon and sigmoideum colon were detected in TH AC group than in regular control group(P<0.05).Adverse events,such as perforation,bleeding,did not occur in both groups.Conclusion Short transparent hood assisted colonoscopy could significantly shorten cecal intubation time and improve the detection of colorectal polyps in single-man method colonoscopy under sedation,especially improve the detection rate of diminutive polyps(W5mm).

关 键 词：透明帽 结肠镜检查 息肉检出率 

分 类 号：R574.62[医药卫生—消化系统]