注水肠镜改善退镜时肠道清洁度的随机对照研究

Water-infusion technique improved the bowel cleanliness during withdrawing the colonscopy: a randomized controlled study

目的采用随机对照试验,比较注水肠镜与传统注气肠镜退镜时的肠道清洁度,探讨注水肠镜的优势。方法选择行非麻醉肠镜检查患者222例,随机分为注水肠镜组(A组)112例和注气肠镜组(B组)110例,比较退镜时肠道清洁度评分与退镜-进镜评分,同时对比患者疼痛评分、肠镜达盲肠时间、插镜深度、全结肠检查率、结直肠腺瘤检出率、操作者主观难易度及检查相关并发症等多项指标。结果 A组退镜清洁度评分明显高于B组[M(8)/IQR(1)vs M(8)/IQR(2),P=0.000],A组退镜-进镜清洁度评分明显高于B组[(0.53±0.74)vs(0.23±0.55),P=0.000],并且A组患者腺瘤检出率(ADR)高于B组(36.61%vs23.64%,P=0.041),A组患者术中腹痛评分明显低于B组[M(2)/IQR(1)vs M(4)/IQR(2),P=0.000];A组操作者主观评价明显优于B组[M(1)/IQR(1)vs M(2)/IQR(1),P=0.005],两组患者在达盲时间、插镜深度和全结肠检查率等方面比较,差异无统计学意义。结论注水肠镜显著改善退镜时的肠道清洁度,同时提高ADR,减轻患者不适感,并且不增加达盲时间。

Objective To compare the effect of water-infusion colonoscopy and conventional air-infusion colonoscopy on the bowel cleanliness during withdrawing.Methods A single blind randomized controlled trial was conducted. 222 patients were randomly divided into water-infusion group （group A, 112 cases） and air-infusion group （group B, 110 cases）. The cleanliness scores, scores improvement, pain scores, time of reaching cecum, depth of colonoscopy, rate of whole colon examination, adenoma detection rate （ADR）, operator’s dififculty and complications were compared between the two groups.Results The cleanliness score during withdrawing was higher in group A [M（8）/IQR（1） vs M（8）/IQR（2）,P = 0.000], the improvement was higher in group A [（0.53 ± 0.74） vs （0.23 ± 0.55）, P = 0.000], the abdominal pain score was signiifcantly lower in group A [M（2）/IQR（1） vs M（4）/IQR（2）,P = 0.000] and the ADR was higher in group A （36.61 % vs 23.64 %,P = 0.041）. The operator’s dififculty evaluation score was signiifcantly lower in group A [M（1）/IQR（1） vs M（2）/IQR（1）,P = 0.005]. There were no signiifcant differences at the time of reaching cecum, the depth of colonoscopy and the whole colon examination rate between the two groups.Conclusion Water-infusion colonoscopy could signiifcantly improve the bowel cleanliness during withdrawing scope, improve the ADR and reduce abdominal pain of patients, without increasing the time to reach cecum.