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比较 CF-H290I 和 PCF-Q260JI 结肠镜在非镇静、有腹部或盆腔手术史患者中的特点:一项随机对照研究。

Comparison of the characteristics of the CF-H290I and PCF-Q260JI colonoscopes in non-sedated patients with a history of abdominal or pelvic surgery: a randomized controlled study.

机构信息

Department of Gastroenterology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Jiangsu Branch of the National Clinical Research Center for Digestive Diseases, Wuxi, China.

Department of Digestive Endoscopy Center, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Jiangsu Branch of the National Clinical Research Center for Digestive Diseases, Wuxi, China.

出版信息

J Gastroenterol Hepatol. 2024 Mar;39(3):457-463. doi: 10.1111/jgh.16398. Epub 2023 Nov 20.

Abstract

BACKGROUND AND AIM

The purpose of this randomized controlled study was to compare the characteristics of the CF-H290I (high-definition) colonoscope with those of the PCF-Q260JI (high-resolution) colonoscope in non-sedated patients with a history of abdominal or pelvic surgery in an effort to help endoscopists to select more effectively and objectively between the various colonoscopes.

METHODS

A total of 397 patients who underwent colonoscopy at the Affiliated Wuxi People's Hospital of Nanjing Medical University, between August 2022 and October 2022 were randomized to a CF-H290I group (n = 198) or a PCF-Q260JI group (n = 199) using a computer-generated allocation method. We compared the adenoma detection rate (ADR), patient satisfaction with the examination, discomfort associated with colonoscopy including abdominal distension and pain, cecal intubation time, and patient willingness to undergo colonoscopy in the future between the CF-H290I and PCF-Q260JI groups.

RESULTS

There was no statistically significant difference in the overall ADR between the CF-H290I and PCF-Q260JI groups (81 [40.9%] vs 63 [31.7%], Z = 3.674, P = 0.055). However, the ADRs in the transverse colon and left colon were significantly higher in the CF-H290I group (22 [11.1%] vs 6 [3.0%], Z = 9.588, P = 0.002 and 57 [28.8%] vs 37 [18.6%], Z = 5.212, P = 0.017, respectively). More sessile serrated lesions were detected in the CF-H290I group (52 [26.3] vs 30 [15.1%], Z = 7.579, P = 0.006). Patient satisfaction with colonoscopy was better in the PCF-Q260JI group (8.91 ± 1.09 vs 8.51 ± 1.44, t = -3.158, P < 0.01) with less likelihood of discomfort (23 [11.6%] vs 41 [20.7%], Z = 6.144, P = 0.013), The number of patients willing to undergo colonoscopy in the future was significantly greater in the PCF-Q260JI group (168 [84.4%] vs 149 [75.3%], Z = 5.186, P = 0.023). The cecal intubation time was significantly shorter in the CF-H290I group (256.09 ± 155.70 s vs 315.64 ± 171.64 s, P = 0.004). There were no complications such as perforation or bleeding in either group.

CONCLUSION

The CF-H290I and PCF-Q260JI colonoscopes each have advantages when used in patients with a history of abdominal or pelvic surgery. The CF-H290I has higher ADRs in the transverse and left colon whereas the PCF-Q260JI is less painful and better accepted by patients. This study was approved by the Clinical Research Ethics Committee of Wuxi People's Hospital and was registered in the Chinese Clinical Trial Registry (ChiCTR2200063092).

摘要

背景和目的

本随机对照研究旨在比较 CF-H290I(高清)结肠镜和 PCF-Q260JI(高分辨率)结肠镜在有腹部或盆腔手术史的非镇静患者中的特点,以帮助内镜医生更有效地选择各种结肠镜。

方法

2022 年 8 月至 2022 年 10 月,南京医科大学附属无锡人民医院共 397 例患者行结肠镜检查,采用计算机生成的分配方法将其随机分为 CF-H290I 组(n=198)或 PCF-Q260JI 组(n=199)。我们比较了 CF-H290I 组和 PCF-Q260JI 组的腺瘤检出率(ADR)、患者对检查的满意度、结肠镜检查相关的不适,包括腹胀和疼痛、盲肠插管时间以及患者对未来结肠镜检查的意愿。

结果

CF-H290I 组和 PCF-Q260JI 组的总体 ADR 无统计学差异(81 [40.9%] 与 63 [31.7%],Z=3.674,P=0.055)。然而,CF-H290I 组横结肠和左半结肠的 ADR 明显更高(22 [11.1%] 与 6 [3.0%],Z=9.588,P=0.002 和 57 [28.8%] 与 37 [18.6%],Z=5.212,P=0.017,分别)。CF-H290I 组发现更多的无蒂锯齿状病变(52 [26.3%] 与 30 [15.1%],Z=7.579,P=0.006)。PCF-Q260JI 组患者对结肠镜检查的满意度更好(8.91±1.09 与 8.51±1.44,t=-3.158,P<0.01),不适感较轻(23 [11.6%] 与 41 [20.7%],Z=6.144,P=0.013),愿意接受结肠镜检查的患者明显更多(168 [84.4%] 与 149 [75.3%],Z=5.186,P=0.023)。CF-H290I 组盲肠插管时间明显更短(256.09±155.70 s 与 315.64±171.64 s,P=0.004)。两组均无穿孔或出血等并发症。

结论

CF-H290I 和 PCF-Q260JI 结肠镜在有腹部或盆腔手术史的患者中各有优势。CF-H290I 在横结肠和左半结肠的 ADR 更高,而 PCF-Q260JI 则更不痛,患者更易接受。本研究经无锡人民医院临床研究伦理委员会批准,并在中国临床试验注册中心(ChiCTR2200063092)注册。

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