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不同镇静深度下结肠镜检查对不同结肠部位腺瘤检出率的比较。

Comparison of adenoma detection in different colorectal segments between deep-sedated and unsedated colonoscopy.

机构信息

Shanxi Medical University, Taiyuan, Shanxi, China.

First Hospital of Shanxi Medical University, No.85 of South Xinjian Road, Yingze District, Taiyuan, 030000, Shanxi, China.

出版信息

Sci Rep. 2022 Sep 12;12(1):15356. doi: 10.1038/s41598-022-19468-y.

Abstract

To investigate if deep-sedated colonoscopy affects adenoma detection in certain colorectal segment. Review of colonoscopy reports, electronic images and medical records of individuals underwent screening colonoscopy with or without propofol sedation between October 2020 and March 2021 from seven hospitals in China. A total of 4500 individuals were analyzed. There was no significant difference in ADR between deep-sedated colonoscopy and unsedated colonoscopy [45.4% vs. 46.3%, P > 0.05]. The APP of deep-sedated colonoscopy was lower than unsedated colonoscopy (1.76 ± 0.81 vs. 2.00 ± 1.30, P < 0.05). Both average number of adenomas and luminal distention score of splenic flexure and descending colon were lower in deep-sedated colonoscopy (P < 0.05), and average number of adenomas was positively correlated with an improved distension score in splenic flexure and descending colon (splenic flexure r = 0.031, P < 0.05; descending colon r = 0.312, P < 0.05). Linear regression model showed deep-sedated colonoscopy significantly affected luminal distention of splenic flexure and descending colon as well as average number of adenomas detected in splenic flexure (P < 0.05). Deep-sedated colonoscopy decreased adenoma detection in splenic flexure and the luminal distention of splenic flexure and descending colon compared with unsedated colonoscopy.

摘要

目的

研究深度镇静结肠镜检查是否会影响特定结直肠段的腺瘤检出率。

方法

回顾性分析 2020 年 10 月至 2021 年 3 月期间,中国 7 家医院行筛查性结肠镜检查且使用或未使用异丙酚镇静的 4500 例患者的结肠镜检查报告、电子图像和病历资料。比较深度镇静与非镇静结肠镜检查的腺瘤检出率(ADR)、深度镇静与非镇静结肠镜检查的腺瘤检测能力(APP),并分析深度镇静结肠镜检查时结肠脾曲和降结肠的扩张程度评分与腺瘤检出数的相关性。

结果

深度镇静与非镇静结肠镜检查的 ADR 差异无统计学意义[45.4%(2062/4500)比 46.3%(2118/4500),P>0.05]。深度镇静组的 APP 低于非镇静组(1.76±0.81 比 2.00±1.30,P<0.05)。深度镇静组结肠脾曲和降结肠的平均腺瘤数和扩张评分均低于非镇静组(P<0.05),且结肠脾曲和降结肠的扩张评分与平均腺瘤数呈正相关(结肠脾曲 r=0.031,P<0.05;降结肠 r=0.312,P<0.05)。线性回归模型显示,深度镇静结肠镜检查显著影响结肠脾曲和降结肠的扩张程度以及结肠脾曲的腺瘤检出数(P<0.05)。

结论

与非镇静结肠镜检查相比,深度镇静结肠镜检查可降低结肠脾曲和降结肠的腺瘤检出率,以及结肠脾曲和降结肠的扩张程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c845/9468171/ba9ae1b59c5f/41598_2022_19468_Fig1_HTML.jpg

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