自制透明帽在普通单人结肠镜检查中的临床应用价值

Clinical application value of self-made transparent caps in common single-person colonoscopy

摘要:

目的 探讨在普通单人结肠镜检查中应用自制透明帽的临床价值。方法 选择于该院内镜中心行普通结肠镜检查的患者282例，随机分为自制透明帽组（透明帽组，140例）和无透明帽组（对照组，142例）。所有结肠镜检查均由同一经验丰富的高级职称医师完成，比较两组患者的基础临床资料、进退镜时间、息肉位置、息肉检出例数和息肉直径等。结果 透明帽组进镜至回盲瓣时间为（6.21±2.43）min，短于对照组的（6.85±2.71）min（P < 0.05），两组患者盲肠插入成功率和退镜时间比较，差异均无统计学意义（P > 0.05）。透明帽组和对照组息肉检出率分别为47.86%和35.21%，差异有统计学意义（P < 0.05）。透明帽组的小息肉检出率（直径 < 5 mm）高于对照组（P < 0.05）。此外，在升结肠和乙状结肠的息肉检出率上，透明帽组高于对照组（P < 0.05），其他部位则差异无统计学意义（P > 0.05）。在检查过程中和检查后，透明帽组和对照组均未出现不良事件（出血和穿孔）。结论 自制透明帽辅助结肠镜检查可有效减少普通单人结肠镜的进镜时间，提高升结肠和乙状结肠的息肉检出率及小息肉（直径 ≤ 5 mm）的检出率，且自制透明帽价格低廉，更有利于在基层医院推广。

Abstract:

Objective To research the clinical utility value of self-made transparent cap during single colonoscopy.Methods 282 patients were enrolled and randomly divided into the self-made transparent cap group (n = 140) and the control group (n = 142) based on the inclusion and exclusion criteria. All the patients were chosen from the same department and the same hospital, and all single colonoscopy procedures were performed by one experienced physician with senior professional title. General clinical information, location, number and diameters of detected polyps, time of ileocecal valve insertion and withdrawal time were collected and compared between the two groups.Results The self-made transparent cap groups insertion time (6.21 ± 2.43) min was shorter than that in the control group (6.85 ± 2.71) min (P < 0.05). Nevertheless, in the achievement rate of cecal insertion and colonoscopy retreat time between the two groups, there were no significant differences (P > 0.05). The detection rate of polyps in the self-made transparent cap group was higher than that in the control group (47.86% vs 35.21%, P < 0.05). The detection rate of polyps with diameter ≤ 5 mm in the self-made transparent cap group was also higher (P < 0.05). In the ascending colon and sigmoid colon segments, the detection rate of polyps in the self-made transparent cap group was higher than that in the control group (P < 0.05). However, there were no differences in other segments. No complications (perforation and bleeding) were acquired in both groups.Conclusion The self-made transparent cap assisted colonoscopy can effectively reduce the entry time of ordinary single colonoscopy, improve the detection rates of both polyps in the ascending and sigmoid colon and polyps with diameter ≤ 5 mm. Moreover, the self-made transparent cap is cost-effective, which is more conducive for the promotion among primary hospitals.