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油润滑结肠镜检查:更容易且疼痛更少?

Oil-lubricated colonoscopy: easier and less painful?

作者信息

Brocchi E, Pezzilli R, Bonora M, Tomassetti P, Romanelli M, Corinaldesi R

机构信息

Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.

出版信息

Endoscopy. 2005 Apr;37(4):340-5. doi: 10.1055/s-2005-861051.

Abstract

BACKGROUND AND STUDY AIMS

Methods of lubrication are rarely considered to be a matter for study in gastrointestinal endoscopy. We evaluated a new technique, i. e. the release of seed oil in discrete amounts from the tip of the scope during colonoscopy.

PATIENTS AND METHODS

346 consecutive patients prospectively underwent colonoscopy with a standard lubricating method (using water-soluble jelly; group A) or with the standard method plus seed oil (corn oil) instillations through the biopsy channel (group B). The following variables were evaluated in the two groups: the success rate for total intubation, and the time required to reach the cecum; the time needed to examine the colon at withdrawal; the detection rates for colorectal diseases; the level of pain and degree of difficulty associated with the examination. Patients in whom total colonoscopy was not achieved were asked to undergo a further examination in which the other lubricating technique was used.

RESULTS

Successful intubation to the cecum was significantly more frequent ( P < 0.005) in the oil lubrication group (group B, 159/168) than in the control group (group A, 145/170), and less time was needed ( P < 0.001). No significant differences were found with regard to time for examination at withdrawal and detection rates for colorectal diseases. Level of pain and degree of difficulty during colonoscopy were significantly lower in the oil group ( P < 0.001). In the cross-over examinations done in patients in whom total colonoscopy was not achieved, no statistical difference was found between the two groups. We observed no side effects for patients or damage to the instrument.

CONCLUSIONS

The proposed technique could be a simple, safe, and inexpensive method for easier and less painful colonoscopy; moreover, it might facilitate difficult examinations. Further studies are needed to confirm our data and to ensure that the use of this technique is not liable to damage the scope.

摘要

背景与研究目的

润滑方法在胃肠内镜检查中很少被视为一个研究课题。我们评估了一种新技术,即在结肠镜检查过程中从内镜尖端以离散量释放籽油。

患者与方法

346例连续患者前瞻性地接受了结肠镜检查,其中一组采用标准润滑方法(使用水溶性凝胶;A组),另一组采用标准方法并通过活检通道滴注籽油(玉米油;B组)。对两组患者评估了以下变量:全段插入成功率、到达盲肠所需时间、退镜时检查结肠所需时间、结直肠疾病检出率、检查相关的疼痛程度和困难程度。未完成全结肠镜检查的患者被要求采用另一种润滑技术进行进一步检查。

结果

油润滑组(B组,159/168)全段插入至盲肠的成功率显著高于对照组(A组,145/170)(P<0.005),且所需时间更短(P<0.001)。在退镜检查时间和结直肠疾病检出率方面未发现显著差异。油润滑组结肠镜检查期间的疼痛程度和困难程度显著更低(P<0.001)。在未完成全结肠镜检查的患者进行的交叉检查中,两组之间未发现统计学差异。我们未观察到对患者的副作用或器械损坏。

结论

所提出的技术可能是一种简单、安全且廉价的方法,可使结肠镜检查更容易且痛苦更小;此外,它可能有助于困难的检查。需要进一步研究以证实我们的数据,并确保使用该技术不会损坏内镜。

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