改良二甲硅油散使用方法在结直肠癌筛查中的应用

Improved Method of Using Dimethicone Powder in Colorectal Cancer Screening

背景目前应用于结直肠癌筛查的结肠镜检查中,常规二甲硅油散使用方法存在资源浪费的情况。目的找寻一种更经济有效的二甲硅油散使用方法。方法选取2015年1月—2016年6月在重庆市第五人民医院行结肠镜检查的受检者275例为研究对象。采用随机双盲法将受检者分为试验组(136例)和对照组(139例)。肠道准备时,试验组仅口服聚乙二醇4000散,对照组则口服聚乙二醇4000散后,继续予以二甲硅油散;结肠镜检查进镜时,如发现肠道泡沫,两组均予以二甲硅油散兑水冲洗吸引。记录两组进镜时肠道泡沫分级、退镜时肠道泡沫情况、结肠镜检查时间、二甲硅油散使用数量。结果根据剔除标准剔除了7例患者,最终共纳入268例受检者,其中试验组132例、对照组136例。试验组进镜时肠道泡沫分级大于对照组,二甲硅油散使用数量小于对照组,差异有统计学意义(P<0.05);两组结肠镜检查时间比较,差异无统计学意义(P>0.05)。两组退镜时肠道泡沫情况均达标。结论改良二甲硅油散使用方法 (仅在进镜时使用二甲硅油散兑水冲洗)既能够达到结直肠癌筛查中结肠镜检查全结肠无泡沫的要求,又不会延长结肠镜检查时间,二甲硅油散使用量也明显减少,简单易行,可以在今后的结直肠癌筛查中继续使用。

Background Dimethicone are often wasted while used in colonoscopy for colorectal cancer screening with the conventional method currently. Objective To find an economic and effective method of using dimethicone powder in colorectal cancer screening. Methods Two hundred and seventy - five patients underwent colonoscopy in colorectal cancer screening in the Fifth People＆#39;s Hospital of Chongqing during January 2015 to June 2016 were selected as the participants and divided into the experimental group（ n = 136 ） and the control group（ n = 139 ） by a randomized,double - blind method. While bowel preparation,the experimental group only took PEG 4000 orally,the control group orally took both PEG 4000 and dimethicone powder. Both groups received dimethicone powder diluted with water to wash existed air bubbles while inserting the colonoscope. The grade of existed air bubbles while inserting colonoscope,conditions of existed air bubbles while withdrawing colonoscope,duration of examination and dosage of used dimethicone powder were recorded. Results According to the exclusion criteria,7 patients were excluded,and finally a total of 268 patients were included in the trial,including 132 in the experimental group and 136 in the control group. The grade of existed air bubbles in the experimental group was higher than that in the control group while inserting the colonoscope（P ﹤ 0. 05）. Dosages of used dimethicone powder in the experimental group were less than those in the control group（P ﹤ 0. 05）. There was no significant difference in duration of examination between the two groups（ P ﹥ 0. 05） . The conditions of existed air bubbles while withdrawing colonoscope in both groups were up to standard. Conclusion The improved method of using dimethicone powder （ only for washing air bubbles while inserting colonoscope）can achieve the same effect as the conventional method with no air bubbles existing in colorectal lumen during the examination but applying much less dosage. Furthermore,it is simple and easy to use without prolonging the duration of examination. In view of these,it can be applied to colorectal cancer screening in the future.