CAJ | 학술논문

目的探讨静脉麻醉下联合胃肠镜检查中,先做胃镜对肠道清洁度有无不利影响,为合理检查顺序提供参考.方法单中心随机盲法观察性研究.65例患者随机分成A组(先做胃镜后做结肠镜)和B组(先做肠镜后做胃镜组),根据改良波士顿肠道准备评分标准评估2组肠道清洁度,并比较2组丙泊酚用量、肠镜达盲时间、在操作室总时间、麻醉诱导和恢复时间以及不良事件发生情况.结果 2组全结肠清洁度差异无统计学意义(6.72±1.34比6.89±1.50;t=-0.473,P=0.638),而回盲部清洁度差异有统计学意义(1.21±0.54比1.55±0.73;t=-2.158,P=0.035).2组间操作时间、丙泊酚用量和不良事件发生率等差异无统计学意义.结论静脉麻醉下联合胃肠镜检查时先肠镜后胃镜组回盲部清洁度优于先胃镜后肠镜组,而全结肠清洁度组间差异无统计学意义.对怀疑回盲部病变的患者,若行联合胃肠镜检查,可考虑优先行肠镜检查.
목적 탐토정맥마취하연합위장경검사중,선주위경대장도청길도유무불리영향,위합리검사순서제공삼고.방법 단중심수궤맹법관찰성연구.65례환자수궤분성A조(선주위경후주결장경)화B조(선주장경후주위경조),근거개량파사돈장도준비평분표준평고2조장도청길도,병비교2조병박분용량、장경체맹시간、재조작실총시간、마취유도화회복시간이급불량사건발생정황.결과 2조전결장청길도차이무통계학의의(6.72±1.34비6.89±1.50;t=-0.473,P=0.638),이회맹부청길도차이유통계학의의(1.21±0.54비1.55±0.73;t=-2.158,P=0.035).2조간조작시간、병박분용량화불량사건발생솔등차이무통계학의의.결론 정맥마취하연합위장경검사시선장경후위경조회맹부청길도우우선위경후장경조,이전결장청길도조간차이무통계학의의.대부의회맹부병변적환자,약행연합위장경검사,가고필우선행장경검사.
Objective To evaluate the impact of sequence on the quality of bowel preparation in patients with anesthesia for same-day sequential bidirectional endoscopy and propose the optimal procedural sequence.Methods Single center blinded randomized observational study.Sixty-five patients were randomized to either the gastroscopy-first group or the colonoscopy-first group.Bowel cleanliness according to Boston bowel preparation scale (BBPS) scores were evaluated,also done the propofol dosage,caecal intubation time,procedure duration and complications.Results The BBPS score of entire colon showed no difference (6.72 ± 1.34 vs.6.89 ± 1.50,P =0.638),but the BBPS of ileal-cecum portion was higher in the colonoscopy-first group (1.21 ±0.54 vs.1.55 ±0.73,P =0.035).The total procedure time,propofol dosage and complications were similar between the two groups.Conclusion The bowel cleanliness of ileal-cecum portion in colonoscopy-first group is better than that of gastroscopy-first group during sequential bidirectional endoscopy in patients with propofol sedation.We propose colonoscopy first in patients with suspicious ileal-cecum lesion.