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[结肠镜检查质量与穿孔的外科治疗]

[Quality of colonoscopy and surgical treatment of perforations].

作者信息

Achiam M, Rosenberg J

机构信息

H:S Hvidovre Hospital, gastroenheden, kirurgisk og medicinsk sektion.

出版信息

Ugeskr Laeger. 2001 Feb 5;163(6):775-8.

Abstract

INTRODUCTION

Perforation during colonoscopy is a well-known complication. The purpose of our study was to evaluate the incidence of acute surgical intervention due to colonic perforations during endoscopy at our department, and evaluate the rate of incomplete examinations.

METHODS

The latest 4000 colonoscopies performed at Hvidovre Hospital were examined for possible complications and success rate.

RESULTS

Seventeen percent of the colonoscopies were incomplete, mostly due to anatomical difficulties, incomplete bowel preparation, and pain. Twelve (0.3%) of the 4000 patients were operated on due to perforation which occurred during the examination. The mortality rate in these 12 patients was 17% and the survivors had a median hospital stay of eight days.

DISCUSSION

Future strategy should focus on improving the quality of colonoscopy, thereby increasing the success rate and lowering patient discomfort. Furthermore, the new non-invasive modalities virtual colonoscopy (CT or MRI) should be developed further so that they might substitute all the diagnostic colonoscopies.

摘要

引言

结肠镜检查期间发生穿孔是一种众所周知的并发症。我们研究的目的是评估我院内镜检查期间因结肠穿孔而进行急性手术干预的发生率,并评估检查未完成的比例。

方法

对在Hvidovre医院进行的最近4000例结肠镜检查的可能并发症和成功率进行了检查。

结果

17%的结肠镜检查未完成,主要原因是解剖结构困难、肠道准备不充分和疼痛。4000例患者中有12例(0.3%)因检查期间发生的穿孔而接受手术。这12例患者的死亡率为17%,幸存者的中位住院时间为8天。

讨论

未来的策略应侧重于提高结肠镜检查的质量,从而提高成功率并减轻患者不适。此外,应进一步开发新的非侵入性检查方法——虚拟结肠镜检查(CT或MRI),以便它们可能替代所有诊断性结肠镜检查。

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