黑色先端帽辅助结肠镜对结直肠息肉检出率的影响:一项前瞻性随机对照研究

Black Hood Assisted Colonoscopy for Detection of Colorectal Polyps: A Prospective Randomized Controlled Study

背景:结肠镜为检出各类结直肠息肉的标准方法,然而,常规结肠镜(CC)仍有可能漏诊部分病变。已有文献报道透明帽辅助结肠镜(THAC)可提高结直肠息肉的检出率,但黑色先端帽辅助结肠镜(BHAC)对结直肠息肉检出率的影响尚不明确。目的:评估BHAC对结直肠息肉检出率的影响。方法:前瞻性随机对照分析2014年9月—2015年4月复旦大学附属华东医院接受CC和BHAC检查的1 076例患者的临床资料,比较两组的一般资料、盲肠插入时间、退镜时间,以及息肉检出数、息肉检出率、息肉部位、大小、形态和病理学诊断。结果:与CC组相比,BHAC组盲肠插入时间显著缩短[(6.31±3.51)min对(7.05±4.15)min,P=0.002],退镜时间和盲肠插入率无明显差异(P>0.05)。BHAC组息肉检出率显著高于CC组(65.4%对48.7%,P=0.004),两组息肉大小和形态均无明显差异(P>0.05)。两组均未发生出血、穿孔等并发症。结论:与CC相比,BHAC可显著提高结直肠息肉检出率,并可显著缩短盲肠插入时间。

Background： Colonoscopy is considered as a standard method for detecting various kinds of colorectal polyps.However,conventional colonoscopy（ CC） still has the chance to miss some lesions. Literatures have already reported that transparent hood assisted colonoscopy（ THAC） can improve the detection of colorectal polyps. However,the effect of black hood assisted colonoscopy（ BHAC） on detection of colorectal polyps is still unclear. Aims： To evaluate the effect of BHAC on detection of colorectal polyps. Methods： A total of 1 076 patients underwent CC and BHAC from Sept. 2014 to April 2015 at Huadong Hospital Affiliated to Fudan University were enrolled in this prospective randomized controlled study.Baseline characteristics,cecal intubation time,withdrawal time,number of polyps,detection rate of polyps,location,size,morphology and pathological diagnosis of polyps between two groups were compared. Results： Compared with CC group,cecal intubation time was significantly shorter in BHAC group than in CC group [（ 6. 31 ± 3. 51） min vs.（ 7. 05 ±4. 15） min,P = 0. 002]. No significant differences in withdrawal time and rate of cecal intubation were found between two groups（ P〉0. 05）. Detection rate of polyps was significantly higher in BHAC group than in CC group（ 65. 4% vs.48. 7%,P = 0. 004）. No significant differences in size,morphology of polyps were found between two groups（ P〉0. 05）.Conclusions： Compared with CC,BHAC could significantly improve the detection of colorectal polyps,and shorten cecal intubation time.