Fasih T, Varma J S, Tabaqchali M A
Coloproctology Unit, Department of Surgery, Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP.
Surgeon. 2004 Apr;2(2):107-11. doi: 10.1016/s1479-666x(04)80054-4.
The aim of this study was to prospectively audit the quality of colonoscopy and patient acceptance in a Surgical Coloproctology Unit over a one-year period.
202 consecutive colonoscopies were evaluated over a 12-month period performed by a Consultant, Specialist Registrars and Research fellows. Data where recorded for adequacy of bowel preparation, completion rate, adequacy of sedation, patient tolerance and duration of the procedure. Adequacy of bowel preparation was monitored by scoring bowel content and the percentage of bowel wall visualised. Patients completed a questionnaire to express their sedation satisfaction, discomfort during the procedure and overall satisfaction.
The success rate of bowel preparation was 94%. Completion rate was 90% in intended full colonoscopies by the Consultant and Registrars and 74% by more junior grade endoscopists (overall 86%). The mean dose of midazolam and pethidine was higher in patients with unsatisfactory sedation than those with satisfactory sedation. The pain score was higher when trainees performed the procedure than when performed by the Consultant. Fourteen patients refused to undergo the procedure again due to procedure discomfort (n = 7), inadequate sedation (n = 2) and bowel preparation discomfort (n = 5).
A high completion rate was achieved, compared with published results. However, further improvements are possible especially by improving the performance of junior endoscopists and by ensuring optimal bowel preparation. Patients' tolerance of colonoscopy was highly acceptable but may also be improved by the same methods.
本研究的目的是前瞻性地评估一个外科结直肠病科在一年时间内结肠镜检查的质量和患者接受度。
在12个月期间，由一名顾问医生、专科住院医生和研究员对连续202例结肠镜检查进行了评估。记录了肠道准备的充分性、完成率、镇静的充分性、患者耐受性和检查过程的持续时间。通过对肠内容物评分和观察到的肠壁百分比来监测肠道准备的充分性。患者完成一份问卷，以表达他们对镇静的满意度、检查过程中的不适以及总体满意度。
肠道准备的成功率为94%。顾问医生和住院医生进行的全结肠镜检查预期完成率为90%，低年资内镜医生的完成率为74%（总体为86%）。镇静不满意的患者咪达唑仑和哌替啶的平均剂量高于镇静满意的患者。实习医生进行检查时的疼痛评分高于顾问医生。14名患者因检查不适（n = 7）、镇静不足（n = 2）和肠道准备不适（n = 5）而拒绝再次接受该检查。
与已发表的结果相比，本研究取得了较高的完成率。然而，仍有可能进一步改进，特别是通过提高低年资内镜医生的操作水平和确保最佳的肠道准备。患者对结肠镜检查的耐受性总体上是可以接受的，但通过同样的方法也可能得到改善。
