无痛与常规电子结肠镜检查效果的对照分析

目的通过总结和分析2200例电子结肠镜检查结果,揭示本地下消化道疾病患病情况,同时探讨无痛肠镜的可行性和安全性。方法回顾性分析2200例受检者年龄结构、性别比例和发病情况,同时比较2200例中的无痛肠镜受检者（A组,n=1039）和常规肠镜受检者（B组,n=1161）两组之间的阳性率和不良反应发生情况;A组从静脉依次缓慢注入咪唑安定0.01mg/kg、芬太尼0.001mg/kg和丙泊酚1～1.5mg/kg;B组按常规方法进行肠镜检查;专人评估受检者的术中和术后恢复情况及不良反应。结果结肠镜检查的阳性率91.32%,A、B两组阳性率无差异（P〉0.05）。患病谱依次为慢性结/直肠炎、大肠息肉、痔疮、大肠癌、炎症性肠病、结肠憩室、血管畸形和阑尾结石。严重不良反应发生率为0.14%,A、B两组术中和术后的HR、BP及SpO2无明显差异（P〉0.05）,不良反应发生率A组显著低于B组（P〈0.001）,且肠镜检查成功率A组高于B组（P〈0.05）,用时A组明显短于B组（P〈0.01）。结论无痛电子结肠镜与常规电子结肠镜相比,检出的阳性率无明显差异,但成功率高、操作时间短、受检者和操作医生感觉舒适。不增加不良反应发生率。

Comparison of the effect between painless and conventional electronic colonoscopy

Objective To compare the outcome of 2,200 patients underwent electronic colonoscopy, to investigate the local prevalence of lower gastrointestinal diseases, and to explore the feasibility and safety of painless colonoscopy. Methods The data of 2,200 patients who underwent electronic colonoscopy were analyzed retrospectively, and the positive rate of examination and the incidence of adverse reactions between painless colonoscopy (group A, n = 1,039) and conventional colonoscopy (group B, n = 1,161) were compared. In group A, midazolam ( 0.01 mg/kg), fentanyl (0.001 mg/kg), and propofol (1 ～ 1.5 mg/kg) were slowly intravenously administered before colonoscopy, and in group B, conventional methods of colonoscopy was performed. Specialist assessment of adverse reactions was recorded during and after operation. Results The positive rate of colonoscopy was 91.32%. There was no significant difference between two groups (P > 0.05). The prevalence of disease spectrum was as follows: chronic colitis/proctitis, colon polyps, hemorrhoids, colorectal cancer, inflammatory bowel disease, colonic diverticula, vascular malformations and appendix stone. Serious adverse event was 0.14%.The HR, BP and SpO2 in group A and group B during and after operation was no difference (P > 0.05). The rate of adverse event during colonoscopy in group A was lower than that in group B(P < 0.001), and the success rate of colonoscopy in group A was higher than in group B (P < 0.05). Operation time in group A was significantly shorter than that in group B(P < 0.01). Conclusions In spite of the equal power in the positive rate of disease detection, painless electronic colonoscopy had a higher success rate, shorter operation time, and satisfactory feeling for both doctors and patients.