Hoff G, Bretthauer M, Huppertz-Hauss G, Sauar J, Paulsen J, Dahler S, Kjellevold Ø
Department of Medicine, Telemark Hospital, Skien, Norway.
Endoscopy. 2005 Nov;37(11):1123-6. doi: 10.1055/s-2005-870444.
A new colonoscope (XCF-Q160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon.
280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCF-Q160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients' grading of pain in a questionnaire.
Cecal intubation rates were 85% and 87% for standard and prototype endoscopes, respectively (P = 0.57). On-demand sedation was given to nine (7%) and 15 (11%) of the patients, respectively (P = 0.17). Of the patients, 256 (85%) returned their questionnaire, with 87 (63%) in the standard group and 109 (77%) in the prototype group reporting that they had experienced 'no pain/slight pain' (P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope.
Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation.
已研发出一种新型结肠镜（XCF-Q160AW原型，日本东京奥林巴斯公司），其设计具有额外的被动弯曲功能，以利于通过左结肠弯曲部进行插管。在本研究中，我们调查了该功能能否纳入标准结肠镜而不损害其总体性能，尤其是通过乙状结肠的情况。
泰勒马克医院280例因常规结肠镜检查而转诊的门诊患者被随机分配接受使用标准结肠镜（奥林巴斯140系列）或XCF-Q160AW原型的结肠镜检查。按需给予镇静剂。终点指标为盲肠插管以及患者在问卷中对疼痛的分级。
标准结肠镜和原型结肠镜的盲肠插管率分别为85%和87%（P = 0.57）。分别有9例（7%）和15例（11%）患者按需给予了镇静剂（P = 0.17）。256例（85%）患者返回了问卷，标准组87例（63%）、原型组109例（77%）报告经历了“无疼痛/轻微疼痛”（P < 0.001）。在多因素逻辑回归分析中，在对内镜医师间差异和内镜强化功能的使用进行校正后，所经历疼痛的这种差异仍具有统计学意义。研究中有2例患者此前多次尝试通过脾曲均未成功，使用原型结肠镜成功完成了检查。
使用具有被动弯曲功能的奥林巴斯XCF-Q160AW原型进行检查比使用标准的奥林巴斯140系列结肠镜引起的疼痛更少，且不影响结肠插管的其他内镜功能。
