Kim W H, Cho Y J, Park J Y, Min P K, Kang J K, Park I S
Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Gastrointest Endosc. 2000 Nov;52(5):600-5. doi: 10.1067/mge.2000.109802.
Successful colonoscopy depends on insertion of the instrument to the cecum, precise observation, and minimal patient discomfort during the procedure. The aim of this prospective study was to determine whether certain variables are associated with insertion time and patient discomfort during colonoscopy.
Nine hundred nine consecutive colonoscopic examinations performed by a single endoscopist in patients without obstructive disease of the colorectum were analyzed. Four liters of Colonlyte (Taejun, Seoul, Korea) were used for bowel cleansing, and meperidine (25 mg) was administered intramuscularly 10 minutes before the procedure. The degree of patient discomfort was assessed using a 5-level Likert scale.
Among 909 study patients, colonoscopy was completed to the cecum in 876 patients (96.4%). The adjusted completion rate was 98% and mean insertion time for complete colonoscopy was 6.9+/-4.2 minutes. Colonoscopy caused less patient discomfort than barium enema or esophagogastroduodenoscopy. Multivariate logistic regression analysis demonstrated that inadequate bowel cleansing, advanced age, and constipation as an indication are independent factors associated with prolonged insertion time (>10 minutes). Female gender was the only independent factor associated with significant discomfort (> or = level 4) during colonoscopy.
Among the factors affecting insertion time and patient discomfort during colonoscopy, unsatisfactory bowel preparation was the only correctable factor.
成功的结肠镜检查取决于将器械插入盲肠、精确观察以及检查过程中患者的不适感降至最低。这项前瞻性研究的目的是确定某些变量是否与结肠镜检查期间的插入时间和患者不适感相关。
分析了由一名内镜医师对909例无结直肠梗阻性疾病的患者进行的连续结肠镜检查。使用4升Colonlyte（韩国首尔太峻公司生产）进行肠道清洁，并在检查前10分钟肌肉注射哌替啶（25毫克）。使用5级李克特量表评估患者的不适程度。
在909例研究患者中，876例（96.4%）的结肠镜检查完成至盲肠。调整后的完成率为98%，完整结肠镜检查的平均插入时间为6.9±4.2分钟。结肠镜检查引起的患者不适感低于钡剂灌肠或食管胃十二指肠镜检查。多因素逻辑回归分析表明，肠道清洁不充分、高龄和以便秘为指征是与插入时间延长（>10分钟）相关的独立因素。女性是结肠镜检查期间与显著不适（≥4级）相关的唯一独立因素。
在影响结肠镜检查插入时间和患者不适感的因素中，肠道准备不充分是唯一可纠正的因素。
