作者单位：515041 汕头，汕头潮南民生医院内镜中心

透明帽辅助单人结肠镜检查在结肠镜检查困难患者中的临床应用

胡辉荆绪斌邹细岩吴锦雄辛汉城

【摘要】目的探讨透明帽辅助单人结肠镜检查在结肠镜检查困难患者中的临床应用。方法对有便秘或腹部手术史的行结肠镜检查的388例患者，按照入组顺序分为奇数组及偶数组，奇数组采用常规单人结肠镜检查法，偶数组采用透明帽辅助单人结肠镜检查法。比较2种检查方法的成功率、平均到达回盲部时间、进入回肠末端成功率及时间、息肉检出率、平均疼痛评分及并发症情况。结果透明帽辅助结肠镜检查法操作成功率较高、平均到达回盲部时间、进入回肠末端时间少于常规结肠镜检查法，结果分别为(91% vs. 79%, P=0.001)、[(7.4±1.8) min vs. (10.7±2.5) min, P=0.01]、[ (15.2±4.0) s vs. (26.3±7.3) s, P=0.001]，但2组进入回肠末端成功率比较差异无统计学意义(92% vs. 90%, P=0.43)；平均疼痛评分透明帽辅助组为(4.4±0.8)分，常规检查组为(5.8±1.3)分，比较差异有统计学意义(P=0.02)。2组息肉检出率比较有差别，透明帽辅助组高于常规组(50% vs. 31%， P=0.001)，2组均未出现严重并发症。结论对有便秘或腹部手术史的患者，透明帽辅助结肠镜操作法安全、有效，对患者造成痛苦更小。

【关键词】透明帽；结肠镜；临床应用

DOI:10.3969/g.issn.0253-9802.2015.02.013

基金项目：广东省科技计划项目(2013137)

通讯作者，胡辉，E-mail: huhuiasd@sina.com

收稿日期：(2014-11-06)

Application of transparent cap-assisted colonoscopy in difficult patients with colonoscopyHuHui,JingXubin,ZouXiyan,WuJingxiong,XinHancheng.DepartmentofEndoscope,ShantouChaonanMinshengHospital,Shantou515041,China

Correspondingauthor，HuHui，E-mail：huhuiasd@sina.com

Abstract【】ObjectiveTo evaluate the clinical application of transparent cap-assisted colonoscopy in difficult patients with colonoscopy. MethodsA total of 388 patients with constipatin or history of abdominal operation and undergoing colonoscopy in Shantou Chaonan Minsheng Hospital were recruited and divided into two groups based upon odd/even sequence number: conventional colonoscopy (n=194) and transparent cap-assisted colonoscopy groups (n=194). The success rate, mean time of cecal intubation, success rate and time of terminal ileum intubation, detection rate of poly, mean pain score and incidence of complications were statistically compared between two groups. ResultsCompared with conventional colonoscopy group, the success rate was significantly higher (91% vs. 79%, P=0.001), average time of cecal intubation time (7.4±1.8 min vs. 10.7±2.5 min, P=0.01) and time of terminal ileum intubation (15.2±4.0 s and 26.3±7.3 s, P=0.001) were significantly shorter in the transparent cap-assisted colonoscopy group. However, the success rate of terminal ileum intubation did not significantly differ between two groups (92% vs. 90%, P=0.43). Average pain score in the transparent cap-assisted colonoscopy group was 4.4±0.8, significantly lower than 5.8±1.3 in the conventional colonoscopy group (P=0.02). The detection rate of polyp in the transparent cap-assisted colonoscopy group was 50%, significantly higher compared with 31% in the conventional colonoscopy group (P=0.001). No complications were observed in two groups. ConclusionsTransparent cap-assisted colonoscopy is a safe and efficacious approach and yields mild pain, which should be recommended for patients with constipatin or history of abdominal operation.

【Key words】Transparent cap; Colonoscopy; Clinical application

结肠镜检查是目前诊断和治疗下消化道疾病最常用和最有效的方法。但由于结肠镜检查是一种侵入性检查，患者检查过程中会感觉不适，有一定的失败率。对一些困难病例，临床上常见的如长期便秘患者、腹部严重外伤、手术病史患者，由于其肠道冗长、弯度大、或肠道间存在黏连，增加了操作难度，结肠镜检查成功率更低[1-2]。……