肠镜用水温度对注水法肠镜影响的临床分析

目的探讨不同温度的肠镜检查用水对注水法肠镜的影响。 方法随机对照单盲研究,纳入2017年8月至2018年2月因体检行肠镜检查患者300例,随机分为三组：注气组100人;注室温水组（22 ℃）100人;注加热水组（38 ℃）100人。由三名内镜医生随机进行单人肠镜操作,记录腹痛评分、达回盲部时间、检查成功率、息肉的检出率、体位变化、腹部按压、肠镜检查满意度、退镜时间、诊断结果等数据。 结果注气组、注室温水组、注加热水组的三组患者的腹痛评分（5.5±4.0;3.0±2.0;3.0±1.0）、达回盲部时间（187.00±131.25 s;268.00±89.50 s;250±103.50 s）、退镜时间（137.5±62.00 s;156.50±76.25 s;156.00±67.00 s）、肠镜检查满意度（74%;87%;90%）有统计学差异（P<0.05）;三组患者的检查成功率（94%;98%;97%）、息肉检出率（19.15%;24.49%;23.71%）、腹部按压及体位变化等均无统计学差异（P>0.05）;其中,腹痛评分注气组明显高于注水组（P<0.05）,室温水组与加热水组间无差异（P>0.05）;肠镜检查满意度注水组明显高于注气组（P<0.05）,室温水组与加热水组间无差异（P>0.05）;达回盲部时间与退镜时间注水组明显长于注气组（P<0.05）,室温水组与加热水组间无差异（P>0.05）。 结论在非麻醉的肠镜检查中,注水法能够减少患者的腹痛,提高患者满意度,但与注气法相比会延长操作时间。水温的升高对患者的腹痛评分、到达回盲部时间、退镜时间、肠镜检查满意度、检查成功率、息肉的检出率、体位变化及腹部按压等无影响。因此室温水也可用于注水肠镜检查中。

Effect of water temperature on water infusion colonoscopy

ObjectiveTo investigate the effect of different temperature water on water infusion colonoscopy. MethodsThis is a randomized, controlled trial that is carried out from August 2017 to February 2018 at a single center and a total of 300 subjects who underwent colonoscopy examination for cancer screening were included in this study. The patients were randomized to three groups: air insufflation group, cool water group (22℃), warm water group (38℃). The colonoscopy procedures were performed by three experienced endoscopist without any sedation. The following parameters were assessed: patients′ abdominal pain scores evaluated by the visual analogue scales (VAS), the cecal intubation time, the cecal intubation rate, the polyp detection rate, position exchange, abdominal compression, the degree of satisfaction, withdrawal time, diagnosis results. ResultsThere was significance difference in the abdominal pain (5.5±4.0; 3.0±2.0; 3.0±1.0), the cecal intubation time (187.00±131.25s; 268.00±89.50 s; 250±103.50s), withdrawal time (137.5±62.00 s; 156.50±76.25s; 156.00±67.00s) and the degree of satisfaction (74%; 87%; 90%) between the three groups (P<0.05). Other outcomes were no different including the cecal intubation rate (94%; 98%; 97%), the polyp detection rate (19.15%; 24.49%; 23.71%), abdominal compression, position exchange (P>0.05). The abdominal pain scores in the air insufflation group is much higher than two water infusion groups (P<0.05), but there is no difference between the two water infusion groups (P>0.05); the degree of satisfaction in the air insufflation group is much lower than two water infusion groups (P<0.05), but there is no difference between the two water infusion groups (P>0.05); the cecal intubation time and withdrawal time in the two water infusion groups are longer than air insufflation group (P<0.05), there is no difference between the two water infusion groups (P>0.05). ConclusionAlthough water method needs more time to reach the cecum, it can reduce abdominal pain and improve degree of satisfaction compared with the air method. There is no difference between the warm water group and the cool water group in abdominal pain scores, the cecal intubation time, withdrawal time, degree of satisfaction, the cecal intubation rate, the polyp detection rate, abdominal compression, position exchange. Therefore, water do not need to be warmed in water infusion colonoscopy.