三维成像装置在结肠镜检查中的可行性研究

Application of three-dimensional imaging device to colonoscopy

目的评估三维成像装置在结肠镜检查中的初步应用。方法纳入2019年11—12月于首都医科大学附属北京友谊医院行无痛结肠镜检查的患者共60例,每例患者先后进行两次结肠镜检查,按照随机码分为2组,其中30例患者纳入试验组(进镜均使用二维结肠镜,首次退镜使用三维结肠镜,再次退镜使用二维结肠镜),30例患者纳入对照组(进镜均使用二维结肠镜,首次退镜使用二维结肠镜,再次退镜使用三维结肠镜),观察2组息肉检出情况,并进行退镜时间、操作体验、图像质量及并发症的评价。结果试验组首次息肉检出率为77.3%(17/22),高于对照组的43.5%(10/23),2组间差异有统计学意义(χ^(2)=5.351,P=0.021)。试验组10例操作者合并头晕症状,而对照组操作者无头晕症状(P=0.001)。2组首次结肠镜检查检出息肉直径[0.50(0.70)cm比0.30(0.20)cm,U=57.000,P=0.170]、退镜时间[(4.6±1.5)min比(5.2±1.9)min,t=-1.189,P=0.239]、图像质量(2组病变性质识别3分均为27例,腔道识别3分均为28例,P=1.000)差异无统计学意义。2组均无并发症发生。结论三维成像装置在结肠镜检查息肉检出中具有一定的优势,且具有可操作性,可应用于临床。

Objective To evaluate the application of three-dimensional(3D)imaging device to colonoscopy.Methods A total of 60 patients who underwent painless colonoscopy in Beijing Friendship Hospital,Capital Medical University from November to December,2019 were enrolled and divided into 2 groups according to random code.Each patient underwent colonoscopy twice,while 2D colonoscopy was used for cecal intubation.Thirty patients were assigned to the experimental group(primary withdrawal used 3D colonoscopy,and secondary withdrawal used 2D colonoscopy),and 30 others to the control group(primary withdrawal used 2D colonoscopy,and secondary withdrawal used 3D colonoscopy).The detection of polyps,the withdrawal time,operating experience,image quality and complication were evaluated in the two groups.Results The polyp detection rate at the first colonoscopy in the experimental group was 77.3%(17/22),which was higher than 43.5%(10/23)in the control group(χ^(2)=5.351,P=0.021).Ten operators in the experimental group had dizziness,while the operators in the control group had no dizziness(P=0.001).There were no significant differences between the two groups in the polyp diameter[0.50(0.70)cm VS 0.30(0.20)cm,U=57.000,P=0.170],withdrawal time(4.6±1.5 min VS 5.2±1.9 min,t=-1.189,P=0.239)or image quality(27 cases with 3 points in the identification of lesion nature,and 28 cases with 3 points in the identification of duct both in the two groups,P=1.000)at the first colonoscopy.No complication occurred in either group.Conclusion Application of 3D imaging device is feasible for colonoscopic polyp detection,and it can be used in clinical practice.