非麻醉肠镜肠道准备对肠道清洁度及受检者腹痛程度的影响

摘要

Objective To compare the effect of different bowel preparation methods in non-anesthetic enteroscope on the hygienic level of the bowel,the degree of gas,the pain degree,the polyp detection rate and small polyp detection rate.Methods Totally 2 400 patients with non-narcotic colonoscope were selected and randomly divided into 6 groups according to the different treatment.Patients were treated with polyethylene glycol electrolyte powder in group A,polyethylene glycol electrolyte powder and espumisan in group B,polyethylene glycol electrolyte powder and pinaverium bromide in group C,polyethylene glycol electrolyte powder,espumisan and pinaverium bromide in group D,polyethylene glycol electrolyte powder and espumisan,scopolamine in group E,polyethylene glycol electrolyte powder,espumisan and pinaverium bromide,scopolamine in group F.The Boston bowel preparation scale(BBPS) was used to evaluate the hygienic level of the bowel,the degree of bubbles was assessed,and the degree of pain and the rate of polyp and small polyp were recorded by expert colonoscopists.Results There was no significant difference in colon cleaning of bowel preparation among different groups (P ＞ 0.05).The bubble volume (especially in the right-side colon) of patients with espumisan treatment was less than that of patients with polyethylene glycol electrolyte powder treatment alone (P ＜ 0.05).The detection rates of the polyp and small polyp in groups B,D,E,F were significantly higher than those in the other two groups(P ＜ 0.05).The degree of pain in patients treated with pinaverium bromide or scopolamine was less than that in patients treated with polyethylene glycol electrolyte powder alone(P ＜ 0.05).The abdominal pain was relieved after the pinaverium bromide or scopolamine treatment,and the degree of abdominal pain after combined treatment was less than that of scopolamine by intramuscular injection alone(P ＜ 0.05).Conclusion The bowel can be effectively cleaned with polyethylene glycol electrolyte powder,and the gas volume can be effectively reduced by espumisan.The abdominal pain degree of patients with oral pinaverium bromide or intramuscular injection scopolamine can be reduced,and the combination of two drugs show the better effects for relieving pain.%目的 比较不同肠道准备方法对肠道准备清洁度、肠内气泡量、受检者腹痛程度、息肉及微小息肉检出率的影响.方法 接受非麻醉肠镜检查的2 400例门诊患者随机分配到聚乙二醇电解质散组、聚乙二醇电解质散+西甲硅油组、聚乙二醇电解质散+匹维溴胺组、聚乙二醇电解质散+西甲硅油+匹维溴胺组、聚乙二醇电解质散+西甲硅油+东莨菪碱组和聚乙二醇电解质散+西甲硅油+匹维溴胺+东莨菪碱组.由内镜医生及助手根据BBPS评分记录肠道清洁度,评估肠腔内气泡程度,记录受检者腹痛程度和息肉及微小息肉检出率. 结果 6组患者的肠道准备清洁有效性并无明显差异(P＞0.05);加服西甲硅油乳剂的4组患者肠内气泡量(尤其是右半结肠)均少于仅服用聚乙二醇电解质散组(P＜0.05).加服西甲硅油乳剂的4组患者息肉及微小息肉检出率均高于于仅服用聚乙二醇电解质散组(P＜0.05).加服匹维溴胺片或是肌注东莨菪碱均可以减轻患者的腹痛程度,两者合用组患者在操作过程中的腹痛程度低于仅肌注东莨菪碱组(P ＜0.05). 结论 聚乙二醇电解质散能有效清洁肠道,西甲硅油可减少肠内气泡量,口服匹维溴胺片或是肌注东莨菪碱均可以减轻患者的腹痛程度,匹维溴胺片和东莨菪碱二者合用效果更佳.