非泵式注水结肠镜的临床应用研究-第三军医大学学报.docVIP

温水灌注对困难结肠镜检查成功率及腹痛评分的影响 苏军凯，张鸣青，王爱民，刘 将，张 帅，张华玉，李仙丽，吕新芝 （363000福建 漳州，解放军第175医院(厦门大学附属东南医院) 消化内科，南京军区消化内镜中心） [摘要] 目的 探讨温水灌注在困难结肠镜检查中的应用价值。方法 结肠镜初学者初次检查不能成功到达回盲部的门诊患者134例，定义为困难结肠镜，随机分为注水组和注气组。注水组采用活检孔道灌注温水法获得肠腔视野，注气组采用传统注气法获得肠腔视野，由教员再次结肠检查。比较两组结肠镜检查成功率及患者腹痛评分等差异。结果 注水组与注气组之间，年龄、性别组成、腹部手术史、便秘以及BMI均无显著性差异。注水组结肠镜到达回盲部成功率为94.03%（63/67），明显高于注气组的79.10%（53/67）（P=0.021）。注水组患者腹痛评分为(3.33±1.60)分，明显低于注气组(4.74±1.74)分（P=0.000）。结论 温水灌注是一种有效提高困难结肠镜检查成功率、减少患者腹痛程度的方法。 [关键词] 困难结肠镜；温水灌注；回盲部到达率；腹痛评分 [中图法分类号] [文献标志码] A A Randomized Controlled Trial of Warm Water Consumption to Increase Cecal Intubation Rate in difficult Colonoscopy Su Junkai, Zhang Mingqing, Wang Aimin, Liu Jiang, Zhang Shuai，Zhang Huayu,Li Xianli,Lv Xinzhi(Department of gastroenterology, the 175th Hospital of PLA, Southeast Hospital of Xiamen University, Digestive Endoscopy Centre of Nanjing Command, Zhangzhou, Fujian Province,363000, China) [Abstract] Objective To determine the effect of warm-water infusion in lieu of air insufflation during unsedated difficult colonoscopy. Methods 134 outpatients of unsedated colonoscopy which were failure in trainees performs, were randomly assigned to the group of warm-water infusion (water group) and traditional air insufflation group (gas group). The cecal intubation rate and abdominal pain score were compared between water group and gas group. Result There was no difference between the gas group and air group for the age, agenda, abdominal surgery history, constipation and body mass index. The cecal intubation rate of water group was 94.03%（63/67）, which was significantly higher than 79.10%（53/67）of gas group（P=0.021）. The abdominal pain scores of water group was 3.33±1.60, which was significantly lower than 4.74±1.74 of gas group（P=0.000）. Conclusion Warm-water infusion in lieu of air insufflation could increase the cecal intubation rate during unsedated difficult colonoscopy. [Key words] Difficult Colonoscopy, Warm-wat