无痛单人操作大肠镜的临床价值

Value of the painless single-operating colonoscopy

目的临床评价无痛单人操作法行大肠镜诊断大肠疾病的有效性、安全性。方法同期1026例大肠镜检查患者分为无痛单人操作组、无痛双人操作组、普通单人操作组、普通双人操作组。无痛组使用异丙酚联合芬太尼或咪唑安定静脉麻醉。记录所有患者肠镜检查中血压、心率、血氧饱和度变化及到达回盲部时间、成功率、不良反应和满意率。结果无痛单人组到达回盲部时间明显短于其他组(P=0.001);无痛组到达时间短于普通组(P=0.03)。无痛组成功率98.9%,普通组成功率93.9%;无痛组不良反应显著低于普通组(P=0.001);无痛组1级满意率95.1%,普通组满意率为4.6%。结论无痛单人操作大肠镜安全有效、舒适,不仅能提高效率,节约人力资源,而且可提高检查成功率和减少不良反应,值得大力推广。

【Objective】 To evaluate the efficiency and safety of painless and single-operating colonoscopy.【Methods】1026 patients for colonoscopy were divided randomly into four groups：group painless and single-operating,group painless and double-operating,group single-operating and group double-operating.The blood pressure,heart rate,respiratory rate,SPO2,running time,achievement ratio,adverse reaction and the ratio of satisfaction were monitored during the colonoscopy.【Results】The running time in group painless and single-operating colonoscopy was shorter than other groups（P =0.001）.The achievement ratio was 98.9% in group painless colonoscopy,which was 93.9% in group control.Adverse reaction was lower in group painless colonoscopy than in group control（P = 0.001）.The ratio of satisfaction were also higher in group painless than in group control.【Conclusions】 Colonoscopy with painless and single-operating technique is safe,efficient and comfortable,which can not only improve efficiency of examination,save human resources and improve achievement ratio,but also decrease the adverse reaction.Therefore,we can draw the conclusion that the painless and single-operating colonocopy has the great value in diagnosis and treatment of colonel and rectal disease,and it should be generalized to application.