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对难以接受结肠镜检查的患者行双气囊内镜与磁共振成像增强的结肠镜检查,一项随机研究

发布日期:2014-1-29 12:40:34 文章来源:Endoscopy 作者次数:1167
    对难以接受结肠镜检查的患者行双气囊内镜与磁共振成像增强的结肠镜检查,一项随机研究

    T. Suzuki1, M. Matsushima1, Y. Tsukune1, M. Fujisawa1, T. Yazaki1, T. Uchida1, S. Gocyo1, I. Okita1, K. Shirakura1, K. Sasao1, T. Saito1, I. Sakamoto1, M. Igarashi1, J. Koike1, A. Takagi2, T. Mine1

    1日本神奈川县伊势原东海大学医学院内科胃肠病和肝病部

    2日本神奈川县伊势原市东海大学医学院内科部普通内科     

    背景和研究目的:研究已估计将达10%的病例不能成功接受采用常规结肠镜的盲肠插管术。目前已证明双气囊内镜DBE)系统、磁共振内镜成像(MEI)和透明帽可提高结肠镜检查的成功率。本研究采用一种随机对照的方式,评估在结肠镜检查不完全或技术存在困难的情况下双气囊内镜对完整的结肠检查的效用,并与磁共振内镜成像加透明帽(MEI-Cap)相比较。

    患者和方法:随机分配94结肠镜检查不完全或技术上难以对其进行完全检查的患者,使一半(即47例)接受双气囊内镜,一半接受结肠镜检查联合MEI-Cap。主要终点指标是30min内的盲肠插管率。次要终点指标包括插管时间,采用视觉模拟评分表所得的疼痛评分,腹压尝试次数,镇静药物的剂量以及结肠镜检查期间病人位置的变化情况。

    结果:两组病人所表现的特征相当。DBE30分内盲肠插管率显著高于MEI-Cap组,分别为95.7%45 /4772.3 %34 /47),P=0.0049DBE组到达盲肠的平均时间显著低于MEI-Cap组,分别为13.0 ± 5.3分和16.4 ± 4.8 minutesP = 0.0003。两组均未出现并发症

    结论:对于结肠镜检查不完全或技术上难以对其进行完全检查的患者,双气囊内镜比磁共振内镜成像加透明帽对结肠检查更完全。

     

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    Double-balloon endoscopy versus magnet-imaging enhanced colonoscopy for difficult colonoscopies, a randomized study

    T. Suzuki1, M. Matsushima1, Y. Tsukune1, M. Fujisawa1, T. Yazaki1, T. Uchida1, S. Gocyo1, I. Okita1, K. Shirakura1, K. Sasao1, T. Saito1, I. Sakamoto1, M. Igarashi1, J. Koike1, A. Takagi2, T. Mine1

    1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan

    2General Internal Medicine, Department of Internal Medicine, TokaiUniversitySchoolof Medicine, Isehara,Kanagawa,Japan

    Background and study aims: Studies have estimated that failure of cecal intubation occurs with conventional colonoscopy in up to 10 % of cases. Double-balloon endoscopy (DBE) systems, magnetic endoscope imaging (MEI), and transparent cap have been shown to improve success rates for colonoscopy. This study evaluated the utility of DBE for complete examination of the colon compared with MEI plus cap (MEI-Cap) after incomplete or technically difficult colonoscopy in a randomized comparative manner.

    Patients and methods: A total of 94 patients with incomplete or technically difficult colonoscopy were randomly assigned to receive either DBE (n = 47) or colonoscopy with MEI-Cap (n = 47). The primary end point was cecal intubation rate within 30 minutes. Secondary end points included intubation time, pain score using a visual analog scale, abdominal pressure attempts, doses of sedative medication, and changes in patient position during colonoscopy.

    Results: Patient characteristics were comparable in both groups. Cecal intubation rate within 30 minutes was significantly higher for DBE (45 /47, 95.7 %) than for MEI-Cap (34 /47, 72.3 %) (P=0.0049). Mean time to reach the cecum was significantly lower in the DBE group (13.0 ± 5.3 minutes) than in the MEI-Cap group (16.4 ± 4.8 minutes; P = 0.0003). No complications were encountered in either group.

    Conclusion: DBE is more useful for complete examination of the colon than MEI-Cap in patients with incomplete or technically difficult colonoscopy.

     

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