Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
Colorectal Dis. 2012 Oct;14(10):e735-9. doi: 10.1111/j.1463-1318.2012.03107.x.
Colonoscopy may need to be rescheduled because of inadequate bowel preparation. We evaluated the effectiveness of colonoscopic enema as rescue for an inadequate 1-day bowel preparation before colonoscopy.
Patients referred for afternoon colonoscopy were prospectively enrolled in the study during a 1-year period. Patients took bowel preparation (polyethylene glycol) solution on the morning of the endoscopy. If during colonoscopy the bowel preparation was poor, an enema of polyethylene glycol solution (500 ml) was instilled into the colon at the level of the hepatic flexure via the biopsy channel of the colonoscope which was then removed. The patient was allowed to recover from the propofol sedation and used the bathroom to evacuate the enema. The colonoscope was then introduced and the examination continued.
Of 504 patients undergoing colonoscopy, 26 (4.9%) received an enema. The median age was 59 (29-79) years and 19 (73%) were female. A subsequent successful colonoscopy was achieved in 25/26 (96%). There were no complications. The mean time spent for the entire colonoscopy from the initial preparation to the end of the examination including the enema was 7.6± 1.1h (5.4 h preparation, 0.2h first colonoscopy+enema, 0.66h waiting in the lavatory, 0.33h second colonoscopy and 1 h for recovery).
Colonoscopic enema was highly successful as rescue for patients with inadequate bowel preparation and avoided postponement of the procedure.
由于肠道准备不足，可能需要重新安排结肠镜检查。我们评估了结肠镜检查前 1 天肠道准备不足时结肠镜检查中使用结肠灌洗作为补救措施的效果。
在为期 1 年的时间里，前瞻性地招募了在下午进行结肠镜检查的患者。患者在内镜检查当天上午服用聚乙二醇溶液进行肠道准备。如果结肠镜检查时肠道准备不佳，则通过结肠镜的活检通道向肝曲水平向结肠内注入 500ml 的聚乙二醇溶液。然后将结肠镜取出，患者从异丙酚镇静中恢复过来，并使用浴室排空灌肠液。然后将结肠镜插入并继续进行检查。
在 504 例行结肠镜检查的患者中，有 26 例（4.9%）接受了灌肠。中位年龄为 59 岁（29-79 岁），其中 19 例（73%）为女性。26 例患者中有 25 例（96%）随后成功完成了结肠镜检查。无并发症发生。从最初的准备到检查结束（包括灌肠），整个结肠镜检查过程平均用时 7.6±1.1 小时（5.4 小时准备，第一次结肠镜检查+灌肠 0.2 小时，在浴室等待 0.66 小时，第二次结肠镜检查 0.33 小时，恢复 1 小时）。
结肠镜检查中使用结肠灌洗作为补救措施对肠道准备不足的患者非常成功，可以避免手术推迟。
