结肠镜检查时退镜时间和结直肠息肉发现率的回顾性分析

Withdrawl time of colonoscopy and detection rate of colorectal polyps- a retrospective study

目的 探讨结肠镜检查时退镜时间和结直肠息肉发现率的关系.方法 选取我院2012年6月～2012年8月接受结肠镜检查的患者556例,按息肉的有无分为有息肉组和无息肉组两组,并比较两组患者年龄、性别、肠道清洁度、息肉位置、大小、病理类型及完成全结肠镜检查的例数和退镜时间的差异,进一步将息肉组按退镜时间长短分为＜2分钟、2～4分钟、4～6分钟和＞6分钟4组,比较不同退镜时间息肉发现率的差异.结果 受检者556例,发现结直肠息肉者158例,无息肉者398例,两组患者性别、肠道清洁度及完成全结肠检查例数比较差异无统计学意义（P＞0.05）,两组患者年龄及退镜时间比较差异有统计学意义（P＜0.01）.不同退镜时间组受检者的年龄比较差异无统计学意义（P＞0.05）.Logistic回归分析显示,随着退镜时间的延长,息肉发现率逐渐增加,且差异有统计学意义（P＜0.01）,随退镜时间延长,息肉发现数目增加,Spearman相关分析显示两者的相关系数为0.32（P ＜0.01）.结论 结直肠息肉的发现率和发现数目随退镜时间的延长而增加,结直肠镜检查时退镜时间应＞6分钟.

Objective To study the relationship between with＆awl time of eolonoseopy and detection rate of eoloreetal polyps. Method Five hundred and fifty-six eases were received eolonoscopy in Beijing Freindship Hospital from June 1,2012 to August 1,2012 and were divided into two groups accord- ing to polyp present. The age, gender, intestinal cleanness, position, size, pathological type of the polyp, withdrawl time as well as eases with complete eolonoseopy were recorded. The differences between the two groups on the above factors were analyzed. According to withdrawl time, the polyp group was further divided into 〈 2 min,2 -4 min,4 - 6 min, 〉 6 min four groups. Polyp detection rate between these four groups were assessed. Results Of all the 556 cases,158 eases had polyps and 398cases didnt have polyps. There was no significant difference between the two groups on gender（ P = 0. 177 ） , intestinal deanness （P = 0. 806） and numbers of complete coloscopy insertion （P = 1. 000）. Differences of age and back mirror time between these two groups were statistically significant（ both P 〈 0. 001 ）. And after the stratification, compared age among these groups, difference was not significant （ P = 0. 212 ）. Logistic regression analysis revealed that polyp detecton rate increased gradually with the length of the withdrawl time, and the numbers of polyps were also increased. Spearman correlation analysis showed that the correlation coefficient was 0. 323 （P 〈 0.01 ）. ConcLusion Detection rate and the numbers of colorectal polyps were in- creased with the withdrawl time. The withdrawl time of colonoscopy should be above 6 min.