左半结肠水交换结肠镜检查比较常规注气结肠镜检查的临床效果分析  

Clinical effects of left-colon water exchange colonoscopy vs conventional air-insufflation colonoscopy

作　　者：冷芳 叶长根 戴华梅 胡娜 朱晓佳 方军 向阳 杨力 Fang Leng;Chang-Gen Ye;Hua-Mei Dai;Na Hu;Xiao-Jia Zhu;Jun Fang;Yang Xiang;Li Yang(Department of Gastroenterology,Third People’s Hospital of Jingdezhen,Jingdezhen 333000,Jiangxi Province,China)

机构地区：[1]江西省景德镇市第三人民医院消化内科,江西省景德镇市333000

出　　处：《世界华人消化杂志》2021年第16期972-976,共5页World Chinese Journal of Digestology

基　　金：江西省景德镇市科技计划项目,No.20192SFZC014.

摘　　要：背景常规注气结肠镜检查最为困难的部分在左半结肠,插镜过程中患者可有明显不适,有研究报道水交换技术可明显减轻内镜检查过程中患者的疼痛和不适感,然而,左半结肠水交换技术与常规注气比较效果如何,目前与之相关的研究尚少.目的比较左半结肠水交换(water exchange,WE)结肠镜与常规注气(air insufflation,AI)结肠镜检查的临床应用效果.方法2020-06/2020-12,至我院消化内镜中心行结肠镜检查的连续患者,符合纳入标准的患者,按照随机数字表以(1:1)进行随机分为左半结肠WE组与常规AI组,记录两组的盲肠插镜成功率,到达盲肠的进镜时间,退镜时间,腺瘤检出率(adenoma detection rate,ADR),疼痛视觉模拟评分(visual analogue scale,VAS),穿孔等检查相关并发症.结果根据纳入与排除标准,共筛选出276例患者,其中左半结肠WE组139例,常规AI组137例,两组盲肠插镜成功率、退镜时间以及腺瘤检出率差异无统计学意义,但左半结肠WE组较常规AI组进镜时间明显缩短(4.6 min vs 5.3 min;P<0.05),VAS评分更低(2.7 min vs 3.3 min;P<0.05),两组间均无穿孔等检查相关并发症发生.结论左半结肠水交换结肠镜较常规注气结肠镜检查明显缩短进镜时间,减轻患者的疼痛和不适,值得临床选择使用.BACKGROUND The left colon is difficult to detect via conventional air-injection colonoscopy,and patients may have obvious discomfort during intubation.Studies have reported that water exchange technology can significantly reduce the pain and discomfort of patients during endoscopy.However,there are still few studies comparing the clinical effects of left-colon water exchange(WE)colonoscopy with conventional air-insufflation(AI)colonoscopy.AIM To compare the clinical effects of left-colon WE colonoscopy and conventional AI colonoscopy.METHODS Consecutive patients who underwent colonoscopy at our hospital from June 2020 to December 2020 were collected and randomly divided into either a left-colon WE colonoscopy group or a conventional AI colonoscopy group at a ratio of 1:1.The success rate of ileocecal insertion,time to cecal insertion,time to colonoscope withdrawal,adenoma detection rate(ADR),visual analogue scale(VAS)score of pain,and rate of complications were recorded in the two groups.RESULTS A total of 276 patients were included according to the inclusion and exclusion criteria,including 139 cases in the left-colon WE colonoscopy group and 137 cases in the conventional AI colonoscopy group.There were no statistical differences in the success rate of ileocecal insertion,time to colonoscope withdrawal,or adenoma detection rate between the two groups(P>0.05).However,time to cecal insertion was significantly shorter(4.6 min vs 5.3 min,P<0.05)and VAS score was significantly lower(2.7 vs 3.1,P<0.05)in the left-colon WE colonoscopy group than in the conventional AI colonoscopy group.No examination-related complications such as perforation occurred in either group.CONCLUSION Compared with conventional AI colonoscopy,left-colon WE colonoscopy significantly shortens the time to ileocecal insertion and reduces the pain and discomfort of the patients.

关 键 词：结肠镜检查 水交换 进镜时间 

分 类 号：R574.62[医药卫生—消化系统]