不能完成结肠镜检查的原因分析

Analysis of reasons for colonoscopy incompletion

本研究的目的是分析结肠镜检查不能完成的原因。方法 :460 0例结肠镜检查均为本科患者。使用日本 Olympaus生产的 CF- IT2 0 I纤维结肠镜和 CF- XQ2 30电子结肠镜检查。到达结肠末段者 42 4 4例。用粗完成率 (所有不完成的包括在内 )和校正完成率 (排除肠道疾病和大便堵塞者 )比较。结果 :粗的完成率为92 .2 6% ,校正完成率为 96.13%。不能完成的原因 :大便堵塞 2 2例 ,结肠疾病 154例 ,疼痛不能耐受 ,肠道过于弯曲 178例 ,其他原因 2例。粗完成率男性低于女性 (91.32 % ,93.12 % )。大于 70岁的老年人完成率也较低(76.8% ) ,小于 2 0岁的青少年和幼儿完成率 95.0 9%。当采用校正完成率后 ,所有的不同年龄组均无差别。两例外科手术后病人结肠镜检查后穿孔。结论 :粗的完成率受很多因素的影响 ,难以在操作者之间比较 ,校正完成率能将与疾病有关的因素降低到最小。我们的结论是没有任何肠道梗阻及损害 ,完成率可达 96.13%。

Objective:The purpose of this study is to analyse reasons for colonoscopy incompletion Methods:Four-thousand six hundred consecutive colonoscopies were performed Two different models of colonoscopes were utillized All were manufactured by the Olympus Corporation of Japan,including videoendoscope,CF-XQ230,and fideroptic colonoscope,CF-IT20I Completion was defined as the colonoscope touching the end of the colon The completion rates are reported as crude(all cases) and adjusted (excluding incompletions due to stool and disease) Results:The crude completion rate wsa 92 26% and the adjusted rate was 96 13% Reasons for incompletion were stool(n=22),colonic disease(n=154),pain or tortuosity (n=178),and others(n=2) The crude completion rate was lower in man than that in women(91 32% Vs 93 12%) The crude completion rate lower in the old(>70yr,76 8%)and in the very young (<20yr)it was 95 09% When adjusted rates were compared,all of those differences disappeared Two patients suffered from colon perforation (after pelvic surgery) Conclusions:Crude colonoscopy completion rates are affected by a number of factors that may make comparisons between colonoscopists difficult The use of adjusted completion rates minimizes the effect of disease-related factors We conclude that in the absence of any abstructing lesion an expert can perform complete colonoscopy in 96 13%