Bristol分型在提高结肠镜检查结肠癌发现率中的作用研究

The value of Bristol stool form scale in improving the detection rate of colon cancer by colonoscopy

目的探讨Bristol粪便分型(BSFS)在提高结肠镜检查结肠癌发现率中的作用。方法根据BSFS对拟行结肠镜检查的640例患者进行分组,Bristol 1、2型的214例患者为A组,Bristol 3、4型的213例患者为B组,Bristol 5~7型的213例患者为C组。A组采用聚乙二醇电解质4000散+莫沙比利方案准备肠道,B组采用标准聚乙二醇电解质4000散方案,C组采用减量聚乙二醇电解质4000散方案。肠道准备质量由内镜操作医师术中观察肠道清洁程度,同时评估回盲部到达率、平均退镜时间、结肠癌的发现率、不良反应。结果 A组肠道清洁程度好的比例为88.8%(190/214),B组为91.1%(194/213),C组为91.1%(194/213),组间比较,差异无统计学意义(P>0.05)。A组、B组和C组回盲部到达率分别为93.9%、95.8%和96.7%,差异无统计学意义(P>0.05)。平均退镜时间3组比较,差异有统计学意义(P<0.01);其中B组和C组明显短于A组,差异有统计学意义(P<0.01);B组与C组比较,差异无统计学意义(P>0.05)。结肠癌发现率B组和C组明显高于A组,差异有统计学意义(P<0.01);B组与C组比较,差异无统计学意义(P>0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 BSFS可以有效提高结肠镜检查结肠癌的发现率,值得临床推广。

Objective To investigate the value of Bristol stool form scale （BSFS） on improving the detection rate of colon cancer by colonoscopy. Method 640 eligible patients were involved in this study, and were stratified as group A （Bristol 1/2, n=214）, group B （Bristol 3/4, n=213）, and group C （Bristol 5-7, n=213） according to BSFS results, respec-tively. For bowel preparation, group A was given PEG 4000＋mosapride, group B was treated with standard bowel prepa-ration using PEG 4000, and group C was administered with reduced dose of PEG 4000. Quality of bowel preparation was evaluated by the operator, and the colonic cleanliness, ileocecal arrival rate, the average withdrawal time, the detection rate of colon cancer and the adverse reactions were analyzed. Result In group A, B, and C, patients with good colonic cleanliness accounted for 88.8%（190/214）, 91.1%（194/213）, and 91.1%（194/213）, and there were no statistically signifi-cant differences among the three groups （P〉0.05）. The ileocecal arrival time in group A, B, and C were 93.9%, 95.8%, and 96.7%, respectively, which were similar （P〉0.05）. The average withdrawal time was significantly different in the three groups, and the time of group B and C were significantly shorter than that of group A （P〈0.01）, though it was com-parable in group B and C （P〉0.05）. The incidence of adverse reactions in the three groups were similar （P〉0.05）. Conclu-sion BSFS can effectively improve the detection rate of colon cancer.