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1、投稿：笫三军医大学学报温水灌注对困难结肠镜检查成功率及腹痛评分的影响苏军凯张鸣青*王爱民刘将张帅张华玉李仙丽吕新芝解放军第一七五医院(厦门大学附属东南医院)消化内科，南京军区消化内镜中心，福建漳州363000*通讯作者：张鸣青,zmqingX084@sina.com南京军区医学科技创新经费资助项冃(09MA068)摘要目的：在困难结肠镜检查中采用灌注温水代替传统注气法，观察对结肠镜检查成功率及患者腹痛评分的影响。方法：门诊非麻醉结肠镜由初学者检查失败的患者定义为困难结肠镜，随机分为灌注温水法(注水组)和传统注气法(
2、注气组)，比较两组检查成功率及患者腹痛评分。结果：注水组与注气组Z间，年龄、性别组成、腹部手术史、便秘以及BMI均无显著性差异。注水组结肠镜到达回盲部成功率为94.03%(63/67),明显高于注气组的79.10%(53/67)(P二0.021)。注水组患者腹痛评分3.33±1.60,明显低于注气组4.74±1.74(P=0.000)o结论：温水灌注法可提高困难结肠镜检查的成功率，减少患者腹痛程度。关键词：困难结肠镜；温水灌注；回盲部到达率；腹痛评分；ARandomizedControlledTrialofWarm
3、WaterConsumptiontoIncreaseCecalIntubationRateindifficultColonoscopyJunkaiSu,MingqingZhang,ZhangLiqun,AiminWang,JiangLiu,ShuaiZhangandGuifangMa.Departmentofgastroenterology,the175thHospitalofPLA,SoutheastHospitalofXiamenUniversity,DigestiveEndoscopyCentreofNanj
4、ingCommand,Zhangzhou,FujianProvince,363000,ChinaAbstractObjectiveToconfirmtheeffectofwarm-waterinfusioninlieuofairinsufflationduringunsedateddifficultcolonoscopyontheincidenceofcecalintubationrateandabdominalpainscore.MethodsUnsedatedcolonoscopywhichwerefailur
5、eintraineesperforms,wererandomlyassignedtothegroupofwarm-waterinfusion(watergroup)andtraditionalairinsufflationgroup(gasgroup).Thececalintubationrateandabdominalpainscorewerecomparedbetweenwatergroupandgasgroup.ResultTherewasnodifferencebetweenthegasgroupandai
6、rgroupfortheage,agenda,abdominalsurgeryhistory,constipationandbodymassindex.Thececalintubationrateofwatergroupwas94.03%(63/67)，whichwassignificantlyhigherthan79.10%(53/67)ofgasgroup(P=0.021).Theabdominalpainscoresofwatergroupwas3.33±L60,whichwassignificantlylo
7、werthan4.74±1.74ofgasgroup(P=0.000)•ConclusionWarm-waterinfusioninlieuofairinsufflationcouldincreasethececalintubationrateduringunsedateddifficultcolonoscopy.Keywords:DifficultColonoscopy,Warm-waterinfusion,CecalIntubationRate;Abdominalpainscore最近研究表明，结肠镜检查屮采用
8、温水灌注代替传统注气，可减轻结肠镜检杳中的疼痛感，并可提高到达检查成功率IT。Leung等⑷以既往有腹部手术病史的男性患者为研究对象，结果表明温水灌注可以提高困难结肠镜检查的成功率。木研究以“初学者检查不成功的结肠镜检查”定义为困难结肠镜，进一步阐明温水灌注对困难结肠镜检查成功率及腹痛评分的影响。1对象与方法1.1研究对象2011年3月至2012年02月在我
