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女性结肠镜检查盲肠插管时间的相关因素:手术史的影响。

Factors for cecal intubation time during colonoscopy in women: Impact of surgical history.

机构信息

Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang; Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea.

Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.

出版信息

Saudi J Gastroenterol. 2019 Nov-Dec;25(6):377-383. doi: 10.4103/sjg.SJG_9_19.

Abstract

BACKGROUND/AIM: Cecal intubation during colonoscopy is prone to be prolonged in women, which may be related to frequent exposure to pelvic/abdominal surgery. We evaluated the association between Cecal Intubation Time (CIT) and prior episodes of pelvic/abdominal surgery in women.

PATIENTS AND METHODS

A cross-sectional study was conducted on screening participants who underwent colonoscopy. Multivariate regression with parameter estimates (β) was performed to determine the factors affecting CIT, including age, body mass index (BMI), bowel preparation, sedation, diverticulosis, experience of colonoscopists, and a surgical history. Also, subgroup analyses according to type of surgery were performed.

RESULTS

A total of 835 women were enrolled. The mean CIT was 5.82 ± 3.40 min. 323 females (38.7%) had episodes of surgery. The CIT was prolonged in cases performed by non-experienced trainees (β = 3.61, P< 0.001) and with a history of gynecological surgery (β = 0.97, P = 0.001). In the subgroup of non-experienced trainees, lower BMI, poor preparation, and a history of cesarean section significantly prolonged the CIT. Also, the risk for difficult colonoscopy (CIT ≥ 15 min) was increased with a history of cesarean section (odds ratio = 4.43, P= 0.024).

CONCLUSION

A prior episode of gynecological surgery prolonged CIT. Also, cesarean section history was associated with difficult colonoscopy in the examination by non-experienced trainees.

摘要

背景/目的:女性行结肠镜检查时盲肠插管时间往往较长,这可能与频繁暴露于盆腔/腹部手术有关。我们评估了盲肠插管时间(CIT)与女性盆腔/腹部手术史之间的关系。

患者与方法

对行结肠镜检查的筛查参与者进行了横断面研究。采用参数估计(β)的多变量回归来确定影响 CIT 的因素,包括年龄、体重指数(BMI)、肠道准备、镇静、憩室病、内镜医生经验和手术史。还根据手术类型进行了亚组分析。

结果

共纳入 835 名女性。CIT 的平均值为 5.82±3.40 分钟。323 名女性(38.7%)有过手术史。非经验丰富的受训者(β=3.61,P<0.001)和有妇科手术史的患者 CIT 延长(β=0.97,P=0.001)。在非经验丰富的受训者亚组中,较低的 BMI、较差的准备和剖宫产史显著延长了 CIT。此外,剖宫产史增加了困难结肠镜检查(CIT≥15 分钟)的风险(比值比=4.43,P=0.024)。

结论

妇科手术史会延长 CIT。此外,剖宫产史与非经验丰富的受训者检查时的困难结肠镜检查有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfe9/6941456/9cc4b3ba3c00/SJG-25-377-g001.jpg

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