温水灌注法在困难结肠镜检查中的应用研究

目的研究温水灌注法对困难结肠镜检查中的成功率、插镜时间、操作难易度及患者耐受度等方面的影响。方法非麻醉结肠镜检查的排便困难、肠易激综合征(IBS)和既往有盆腔/腹部手术史患者200例,随机分为温水灌注组(实验组)和传统注气法组(对照组),比较两组患者插镜成功率、插镜时间及患者耐受程度等方面的差异。结果 200例患者完成实验,均未发生肠穿孔等并发症。实验组的全结肠检查成功率、达盲时间、操作者满意度和再检意愿均明显高于对照组(P0.05)。在腹部按压和体位变换使用率、腹痛评分方面,实验组明显低于对照组(P0.05)。两组息肉检出率差异无统计学意义(P0.05)。结论温水灌注肠镜能有效提高困难肠镜的患者耐受度、加快插管进程,提高工作效率,是一种理想的进镜法,值得推广。

Warm water infusion versus air insufflation in the application of difficult colonoscopy*

Objective To explore the effects of warm water insufflation applied in difficult colonoscopy on itssuccess rate, insertion time, operation difficulty level and tolerance of patients. Method 200 cases of the difficultdefecation of non-narcotic colonoscopy, IBS and always has a history of pelvic/abdominal surgery patients, wererandomly divided into warm water infusion group (experimental group) and traditional method of air insufflationgroup (control group), then compare the differences of the success rate of the two groups of patients, the insertiontime and degree of tolerance in patients. Results All the patients completed the investigation in this study, neitherbowel perforation nor other complications occurred. Experimental group success rate of the whole colon examination,the insertion time, the operator satisfaction and check again wishes were significantly higher than that of controlgroup (P < 0.05). In abdominal pressure and utilization, abdominal pain scoring position transformation, the formerwas significantly lower than the latter (P < 0.05). In abdominal pressure and utilization, abdominal pain scoringposition transformation, the former was significantly lower than the latter (P < 0.05). There is no significant difference(P > 0.05) in Polyp detection rate. Conclusion Warm water insufflation colonoscopy can effectively improve thetolerance and accelerating the colonoscopy in patients with difficult insertion process, improve work efficiency, and isan ideal method, which is worth of promoting.