注水法行结肠镜检查在便秘患者中的应用

Application of Water Method for Colonoscopy in Patients with Constipation

背景：内镜医师普遍认为便秘患者行结肠镜检查的操作难度较非便秘患者相对增加.目的：分析注水法行结肠镜检查在便秘患者中的效果.方法：选择2010年11月～2011年11月江苏省苏北人民医院便秘患者200例,随机分为注水组和注气组.比较两组进镜时间、退镜时间、疼痛程度、满意度以及操作过程中是否需外界辅助.结果：与注气组相比,注水组患者平均进镜时间、退镜时间均无明显差异,疼痛程度明显降低（3.5±2.3对9.5±4.3,P＜0.05）,满意率显著升高（90.8％对17.6％,P＜0.05）,需外界辅助的发生率明显降低（体位变化：33.7％对73.5％、腹部压迫：16.3％对62.7％、调节镜身硬度：8.2％对21.6％,P＜0.05）.结论：对于便秘患者,注水法行结肠镜检查可明显减轻患者的疼痛不适,对顺利完成结肠镜检查有切实可行的应用价值.

Background：Endoscopists generally think that performing colonoscopy in patients with constipation is relatively more difficult than in patients without constipation.Aims：To study the effect of water method for colonoscopy in patients with constipation.Methods：Two hundred patients with constipation underwent colonoscopy from Nov.2010 to Nov.2011 at Subei People＇ s Hospital were enrolled and randomly divided into water method group and air method group.Scope pushing forward time,scope withdrawing backward time,pain,statisfactory and the need for assistance between the two groups were compared.Results：Scope pushing forward time,scope withdrawing backward time were not significantly different between the two groups.However,pain score was significantly lower in water method group than in air method group （3.5 ± 2.3 vs.9.5 ± 4.3,P ＜ 0.05）,the satisfactory was significantly increased （90.8％ vs.17.6％,P ＜ 0.05）.Furthermore,water method group needed significantly less assistance during the performance of colonoscopy （position changes：33.7％ vs.73.5％ ; abdominal compression：16.3％ vs.62.7％ ; stiffness variation：8.2％ vs.21.6％,P ＜0.05）.Conclusions：For patients with constipation,water method can decrease the discomfort and pain experienced and is helpful for the completion of colonoscopy.