番泻叶联合甘露醇结肠镜检肠道准备的效果观察

结肠镜检是对结肠病变作出定性诊断的较安全、有效的检查方法之一。为保证结肠镜进入顺利和观察满意 ,肠道准备至关重要。为此 ,我们在甘露醇溶液口服的基础上加用番泻叶 ,取得满意效果 ,介绍如下。1　临床资料1 .1　一般资料1 999年 1月至 2 0 0 0年 8月在我院行结肠镜检查的病人 2 0 0例 ,男 1 32例、女 68例 ,年龄 2 3～ 80岁 ,平均 54.1岁。其中长期便秘 54例 ,慢性腹泻 68例 ,腹泻与便秘交替 66例 ,其它 1 2例。随机分为观察组与对照组各 1 0 0例 ,均排除结肠癌所致肠腔癌性狭窄及肠梗阻。1 .2　方法检查前 1 d常规进少渣饮食 ,检查当…     

磷酸钠盐清洁肠道临床观察

目的探讨纤维结肠镜检查前磷酸钠盐清洁肠道的安全性和可行性。方法将2005年1月至2006年5月的66例门诊纤维结肠镜检查患者随机分为实验组和对照组，每组33例，分别采用磷酸钠盐和蓖麻油＋甘露醇作为肠道清洁剂。观察服药期间不适程度、腹泻次数、肠道清洁度、肠道黏膜形态。结果两种肠道清洁方法不影响纤维结肠镜检查。两组患者血清检测指标、肠道黏膜形态差异无统计学意义，实验组患者对肠道准备的耐受性明显优于对照组，检查前后的腹泻次数明显低于对照组。结论磷酸钠盐清洁肠道安全、可靠，不影响对肠道息肉的处理，可降低患者的不适程度和腹泻次数，减轻肠黏膜屏障的损害，可作为结直肠术前的肠道准备。     

大承气汤联合舒泰清在结肠镜检查前肠道准备的效果观察

目的：观察大承气汤联合舒泰清在结肠镜检查前肠道准备的效果。方法：将140例行肠镜检查肠道准备的患者随机分为观察组和对照组,每组70例。观察组患者给予服用大承气汤联合舒泰清进行肠道准备,对照组患者单纯予口服舒泰清进行肠道准备,比较2组患者的肠道清洁度、不良反应发生率及检查疼痛程度。结果：观察组患者的肠道清洁度高于对照组（P <0.05）,不良反应发生率低于对照组（P <0.05）,观察组患者肠镜检查疼痛评分低于对照组（P <0.05）。结论：大承气汤联合舒泰清对于肠道清洁具有良好的效果,具有疼痛轻,不良反应少等优点,值得临床推广应用。     

结肠水疗在结肠镜检查患者肠道准备中的应用

目的 探讨结肠水疗在结肠镜检查患者肠道准备中的应用效果.方法 选择行电子结肠镜检查患者200例,观察组(门诊患者)124例,使用结肠水疗仪配合口服硫酸镁清洁肠道;对照组(住院患者)76例,单纯口服硫酸镁进行肠道准备.结果 观察组肠道清洁效果、到达回盲瓣成功率及患者对肠道准备的耐受程度显著优于对照组(均P<0.05).结论 使用结肠水疗仪配合口服硫酸镬进行肠道准备成功率高,患者痛苦小,易耐受.     

结肠水疗在结肠镜检查患者肠道准备中的应用

目的探讨结肠水疗在结肠镜检查患者肠道准备中的应用效果。方法选择行电子结肠镜检查患者200例,观察组（门诊患者）124例,使用结肠水疗仪配合口服硫酸镁清洁肠道;对照组（住院患者）76例,单纯口服硫酸镁进行肠道准备。结果观察组肠道清洁效果、到达回盲瓣成功率及患者对肠道准备的耐受程度显著优于对照组（均P〈0．05）。结论使用结肠水疗仪配合口服硫酸镁进行肠道准备成功率高,患者痛苦小,易耐受。     

结肠透析机在肠道准备中的应用效果

目的:探讨结肠透析机在肠镜检查、治疗前的肠道准备效果.方法:对60例用结肠透析机行肠道准备(实验组)与50例服用甘露醇(对照组)结肠镜检查、治疗前行肠道准备的患者随机、对照临床研究,以肠道准备质量、患者舒适度为主要疗效评价指标,并记录严重不良事件.结果:研究组与对照组在肠道清洁程度、患者清肠过程中的舒适度方面差异无统计学意义,但对照组共有6例结肠癌并肠腔狭窄患者,其中3例出现肠梗阻,而实验组共有7例结肠癌患者均未发生肠梗阻.结论:用结肠透析机行肠道准备是一种快捷、高效、安全、患者耐受性好的清肠方法.     

糖尿病患者结肠镜检查前肠道准备的研究进展

正结肠镜检查是诊断和干预治疗肠道疾病常用、有效的检查方法。充分良好的肠道准备是保证结肠镜检查的进镜、视野及观察准确性的先决条件。目前普遍用来评价肠道准备情况的指标为肠道清洁度,如果肠道准备不良,清洁度不佳时,将会遮蔽病变和污染镜面,影响检查质量。肠道清洁度受到多种因素影响,患者自身肠道功能和肠道准备方法是主要的影响因素。但随着社会老龄化及糖尿病发病率的上升,以及糖尿病患者并发胃肠道生理功能改     

纤维结肠镜检出大肠癌25例分析

我院2006年4月至2009年9月在308例结肠纤维镜检查中，检出大肠癌25例，检出率8．11％，现将资料分析报告如下。     

结直肠术后联用西沙比利和法莫替丁免留置胃管的临床观察

为观察结直肠手术后联用西沙比利和法莫替丁免留置胃管的临床效果。笔者将62例结直肠手术患者随机分为观察组和对照组，分别就术后胃肠道功能恢复时间及术后并发症发生率方面进行比较。结果示两组间在胃肠道功能恢复时间上比较，无显著差异;两组术后鼻咽肿痛，肺部感染发生率观察组明显少于对照组;但两组腹胀发生率无显著差异。提示结直肠术后联用西沙比利和法莫替丁免留置胃管临床上是可行的，且优越性显著，值得临床推广应用。     

和爽和甘露醇对结肠镜清洁肠道疗效的比较

目的 为需做结肠镜检查和治疗探寻一种快捷、方便、肠道清洁效果好的口服药,为临床提供一种满意的肠道准备方法.方法 采用随机分组方法,将130例患者随机分为复方聚乙二醇电解质散组和甘露醇组,以问卷法和观察法收集资料,比较2组结肠镜肠道清洁度评定分级.结果 口服复方聚乙二醇电解质散方法肠道清洁总有效率为97％,高于甘露醇组的88.0％（P＜0.05）.结论 复方聚乙二醇电解质散清洁肠道效果显著,不良反应发生率低,操作性强,准备时间短,不需要饮食限制,值得临床推广应用,是一种较好的肠道准备方法.     

结肠灌注透析治疗机清洁灌肠中实施护理干预效果评价

目的 探讨护理干预措施在结肠灌注透析治疗机(下称结疗机)清洁灌肠中的临床效果。方法 将60例行结肠镜检查前用结疗机清洁灌肠的病人随机分成两组。观察组30例在清洁灌肠前和灌肠中增加听音乐、腹部按摩等干预措施使病人放松,对照组30例行常规护理。结果 与对照组相比,观察组首次灌注液量多、总灌注液量少、总灌肠时间短、灌肠显效率高(P<0.01,P<0.05)。结论 在结疗机清洁灌肠中,施以针对性干预措施可有效缩短灌肠时间和提高清洁灌肠效果。     

无痛结肠镜下治疗结肠息肉电切除手术临床观察

目的:探讨无痛结肠镜下治疗结肠息肉电切除手术的临床效果。方法:2016年1月—2018年3月入住我院肛肠外科行结肠息肉手术的患者160例,随机分为观察组(无痛结肠镜组)和对照组(常规结肠镜组),各80例。比较两组患者在镜下治疗时长和术后镇静评分、疼痛评分,以及在术前、在插镜到回盲部时、镜下切除息肉时和术后的心率(HR)及血氧饱和度(SPO_2)水平。结果:观察组的治疗时长、镇静评分、疼痛评分均小于对照组,差异有统计学意义(P 0.05);两组患者HR和SPO_2在术前无统计学差异(P 0.05);在插镜到回盲部时和镜下切除息肉时,观察组的HR和SPO_2低于对照组(P 0.05),术后两组的HR和SPO_2差异均无统计学意义。结论:无痛结肠镜下息肉切除术较普通结肠镜安全、用时少、患者的舒适度高,镇静、镇痛效果确切。     

Colonoscopy in asymptomatic individuals with a family history of colorectal cancer

Background This study was performed to evaluate the use of total colonoscopy as the optimal screening test in asymptomatic individuals with a family history of colorectal cancer (CRC). Methods Colonoscopy was performed in 249 asymptomatic individuals who had one or two first-degree relatives (FDRs) with CRC; individuals with three or more FDRs with CRC were excluded. Results Eighty-six colonic lesions were found in 51 individuals (51 of 249; 20.5%). Among these 51 subjects, 27 had neoplastic polyps (n=38) and 29 had metaplastic polyps (n=44). Although no invasive cancer was detected, in 14 individuals the lesions had a high malignancy potential because of their size and histopathology. We did not confirm a statistically significant difference in the incidence of neoplastic polyps according to the number of affected FDRs. Finally, the presence of metaplastic polyps was a very strong indication for the concomitant presence of metaplastic polyps (P<.0001). Conclusions Total colonoscopy is the optimal screening procedure for the examination of asymptomatic individuals with a family history of CRC.     

番泻叶颗粒复合聚乙二醇用于结肠镜检查肠道准备

目的：探讨番泻叶颗粒复合复方聚乙二醇电解质散在结肠镜检查中的肠道清洁效果。方法：将接受结肠镜检查的 240 例患者随机分为对照组和观察组各 120 例,对照组服用 2 L PEG 和安慰剂,观察组服用 2 L PEG 和 20 g 番泻叶颗粒。对比分析两组肠道准备质量、进镜时间以及息肉检出率。结果：观察组的肠道准备合格率为 83.6%,高于对照组的 62.6%（P<0.05）。而进镜时间观察为（18.16±10.11）min,对照组为（20.38±11.01）min,两组比较无统计学差异（P>0.05）,息肉检出率观察组（24.1%）和对照组（16.5%）比较无统计学差异（P>0.05）。结论：番泻叶颗粒复合复方聚乙二醇电解质散可以提高肠道准备质量。     

3种肠道清洁方法效果比较

目的 探讨不同肠道清洁方法用于放大肠镜检查与治疗的效果.方法 将1 296例接受放大肠镜检查与治疗的患者随机分成甘露醇组(378例)、复方聚乙二醇电解质散组(431例)和大肠水疗组(487例),分别采用口服甘露醇、口服复方聚乙二醇电解质散和大肠水疗法进行肠道准备.比较肠道清洁效果和恶心、呕吐、腹痛等不良反应的发生率.结果 大肠水疗组和复方聚乙二醇电解质散组的肠道清洁有效率显著高于甘露醇组(均P＜0.0125);三组恶心、呕吐发生率比较,差异有显著性意义(均P＜0.0125).结论 大肠水疗法的肠道清洁效果明显优于口服甘露醇,不良反应少,但费用较高;复方聚乙二醇电解质散肠道清洁效果与大肠水疗法相似,不良反应相对少.应根据患者的实际情况及经济能力选择最佳的肠道准备方法.     

Colonoscopy training: the need for patience (patients)

Background : The insertion of a colonoscope to the caecum is a difficult technique to teach and to learn. The most commonly used criterion for proficiency is completion rate and early experience is often discouraging. In order to document the learning curve and better define normal progress for the early learning experience, the performance of trainees during their first 100–125 cases was recorded. Methods : The completion rate and time for office colonoscopy were recorded prospectively over a 5‐year period for each of 18 trainees. Trainees’ experience was analysed in groups of 25 cases, numbered chronologically. Completion rate was defined as the number of examinations completed to the caecum by the trainee expressed as a percentage of the number completed by the staff. Results : The mean overall completion rate for trainees was 56.4% (range 27.8–83.9%). For the first five groups of 25 cases, the percentage completion rates (in order from first 25 cases to fifth 25 cases) were 43.1, 52.6, 49.3, 61.8 and 75.1%, respectively. There was a wide variation in completion rates between trainees, but no difference in time taken. (Time for trainees to complete the procedure, in order from the first 25 cases to fifth 25 cases: 18.7, 19.1, 19.4, 17.6 and 17.1 min, respectively.) Conclusions : Early experience in colonoscopy can be discouraging. At least 100 cases are needed to attain a level of proficiency that enables completion in two‐thirds of cases, whereas 125 cases lead to an average completion rate of 75%.     

Colonoscopy for rectal bleeding in childhood.

Undiagnosed rectal bleeding can pose a significant problem in the pediatric patient. A systematic and logical approach to the work-up of the child with rectal bleeding is necessary for prompt and accurate diagnosis. It is our impression that the addition of colonscopy in carefully selected patients will decrease the number of children with undiagnosed significant rectal bleeding.     

Non-entry of eligible patients into the Australasian Laparoscopic Colon Cancer Study

BACKGROUND: There is currently a need to assess the reasons for non-entry of eligible patients into surgical randomized controlled trials to determine measures to improve the low recruitment rates in such trials. METHODS: Reasons for non-entry of all eligible patients not recruited into the Australasian Laparoscopic Colon Cancer Study were prospectively recorded using a survey completed by the participating surgeons for a period of 6 months. RESULTS: In the 6-month period of the study, 51 (45%) out of 113 eligible patients examined by the 18 actively participating surgeons were recruited into the trial. Eighty-nine reasons were recorded for the non-entry of the 62 eligible patients. The most commonly recorded reason was preference for one form of surgery (42%) or the surgeon (31%) by the patient (45 patients (73%) in total). This was followed by lack of time (10 patients (16%)), hospital accreditation (7 patients (11%)) or staffing/equipment (6 patients (10%)). Concern about the doctor-patient relationship or causing the patient anxiety was recorded for three (5%) and two (3%) patients, respectively. Recruitment was positively associated with the availability of a data manager (chi2 = 19.91; P < 0.001, odds ratio (95% confidence interval) = 9.50 (3.53-25.53)) and negatively associated with an increased caseload (more than five eligible patients seen by the surgeon in the study period) (continuity adjusted chi2 = 16.052; P < 0.001, odds ratio (95% confidence interval) = 0.11(0.04-0.30)). CONCLUSION: Having a preference for one form of surgery by the patient or the surgeon was the most common reason for non-entry of eligible patients in the Australasian Laparoscopic Colon Cancer Study. Concern about the doctor-patient relationship played a minimal role in determining the outcome of recruitment. Patient and surgeon preferences, caseload and the distribution of supportive staff such as data managers according to patient population density should be considered in the planning of future trials.