对50岁以下下消化道出血患者进行全结肠镜检查。
Full colonoscopy in patients under 50 years old with lower gastrointestinal bleeding.
作者信息
Khodadoostan Mahsa, Shavakhi Ahmad, Padidarnia Reihaneh, Shavakhi Alireza, Ahmadian Mehdi
机构信息
Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
J Res Med Sci. 2018 May 30;23:45. doi: 10.4103/jrms.JRMS_531_17. eCollection 2018.
BACKGROUND
Lower gastrointestinal (GI) bleeding is a common clinical problem in young patients. The management of this disease in patients is challenging. The aim of this study is to compare sigmoidoscopy with full colonoscopy in these patients.
MATERIALS AND METHODS
In this cross-sectional study, 120 eligible patients under 50 years old with acute rectal bleeding were enrolled. After cleaning the colon, initially the patients underwent sigmoidoscopy. Pain, the comfort of the test by physician and patient, duration of the procedure, and pathologic findings were recorded. The procedure continued until the splenic flexure passed in the ileocecal valve, and this stage was considered as proximal colonoscopy. Pain, easy performance by physician and the patient, duration of procedure, and pathologic findings were recorded in this stage too. The variables in the two stages were compared with each other.
RESULTS
There were 66 women (55%) and 54 men (45%) and the mean of age was 41 ± 7.9 years. Proximal colonoscopy from splenic flexure to reach cecum was relatively easier for the physician and the patient than sigmoidoscopy ( < 0.001). Furthermore, the time spent to carry out proximal colonoscopy was less than the time taken for sigmoidoscopy ( < 0.001). Pathologic findings recorded in full colonoscopy were more than sigmoidoscopy ( < 0.001). Therefore, full colonoscopy that includes sigmoidoscopy and proximal colonoscopy is relatively easier than sigmoidoscopy for patients, and it also proves more advantageous than sigmoidoscopy for physicians to perform in Iranian patients because of more tortuous and elongated sigmoid colon in these patients.
CONCLUSION
It is advised to perform full colonoscopy than sigmoidoscopy in young patients with lower GI bleeding.
背景
下消化道出血是年轻患者常见的临床问题。对这类患者的疾病管理具有挑战性。本研究的目的是比较这些患者的乙状结肠镜检查和全结肠镜检查。
材料与方法
在这项横断面研究中，纳入了120例50岁以下急性直肠出血的符合条件的患者。在清洁结肠后，患者首先接受乙状结肠镜检查。记录疼痛程度、医生和患者对检查的舒适度、操作持续时间以及病理结果。操作继续进行，直到脾曲通过回盲瓣，此阶段被视为近端结肠镜检查。此阶段也记录疼痛程度、医生和患者操作的难易程度、操作持续时间以及病理结果。比较两个阶段的变量。
结果
有66名女性（55%）和54名男性（45%），平均年龄为41±7.9岁。对医生和患者而言，从脾曲到盲肠的近端结肠镜检查相对乙状结肠镜检查更容易（<0.001）。此外，进行近端结肠镜检查所花费的时间少于乙状结肠镜检查（<0.001）。全结肠镜检查记录的病理结果多于乙状结肠镜检查（<0.001）。因此，包括乙状结肠镜检查和近端结肠镜检查的全结肠镜检查对患者来说相对乙状结肠镜检查更容易，并且由于这些患者的乙状结肠更迂曲和冗长，对医生来说在伊朗患者中进行全结肠镜检查也比乙状结肠镜检查更具优势。
结论
建议对下消化道出血的年轻患者进行全结肠镜检查而非乙状结肠镜检查。
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