深镇静和未镇静结肠镜检查中漏检腺瘤的比较：一项多中心回顾性研究

本文由“罂粟花”授权转载  

深镇静和未镇静结肠镜检查中漏检腺瘤的比较：一项多中心回顾性研究

贵州医科大学  麻醉与心脏电生理课题组

翻译：文春雷  编辑：柏雪  审校：曹莹

背景：采用异丙酚深镇静结肠镜检查在我国得到广泛应用。然而，它对质量指标的影响仍然存在争议。我们的目的是研究深镇静结肠镜检查对漏诊腺瘤的影响，特别是在每个结   肠   直肠节段   。  

方法：2020年10月-2021年9月，在七院3710名患者中部分患者首次接受了异丙酚镇静下的结肠镜检查，部分患者无镇静下接受结肠镜检查。六个月内这些患者第二次接受无镇静下结肠镜检查或肠息肉切除。

结果：3710例患者中有1113例漏诊腺瘤。深度镇静结肠镜检查的腺瘤漏诊率（AMR）显著高于未镇静的肠镜检查[19.14%（578/3020）vs. 16.15%（535/3313），P < 0.05]。深镇静结肠镜检查中腺瘤漏诊的风险是未镇静结肠镜检查的1.229倍（OR，1.229；95%CI：1.080–1.399）。中等水平的内窥镜医生在深镇静结肠镜检查中脾曲腺瘤漏诊率为（26.02% [96/369] vs. 16.04% [47/293]，P < 0.05），降结肠腺瘤漏诊率为（20.86% [102/489] vs. 13.37% [54/404]，P < 0.05），明显高于未镇静结肠镜检查（P < 0.05）。

结论：深镇静结肠镜检查的AMR高于未镇静结肠镜检查。此外，与未镇静结肠镜检查相比，深镇静结肠镜检查中脾曲结肠和降结肠的腺瘤更容易被漏诊，特别是在经验不足的内窥镜医生检查时。

原始文献来源：Yue Sui , Yanhua Zheng , Qing Wang,et al.Comparison of missed adenomas in deep-sedated and unsedated colonoscopy: A multicenter retrospective study.[J].European Journal of Internal Medicine,2023:48–53.

英文原文：

Comparison of missed adenomas in deep-sedated and unsedated colonoscopy: A multicenter retrospective study

BACKGROUND: Deep-sedated colonoscopy with propofol is widely used in China. However, its impact on quality metrics remains controversial. We aimed to investigate the effects of deep-sedated colonoscopy on missed adenomas, specifically in each colorectal segment.

METHODS: Data of 3710 individuals from seven hospitals in China who underwent an initial colonoscopy with or without propofol sedation and a second colonoscopy without sedation within six months for surveillance or polypectomy by endoscopist of the same level between October 2020 and September 2021 were retrospectively analyzed.

RESULTS: A total of 1113 missed adenomas in 3710 patients were evaluated. The adenoma miss rate (AMR) was significantly higher in deep-sedated colonoscopy than in unsedated colonoscop [19.14% (578/3020) vs. 16.15% (535/3313), P < 0.05]. The risk of missing adenomas in deep-sedated colonoscopy was 1.229 times higher than in unsedated colonoscopy (OR, 1.229; 95% CI: 1.080–1.399). AMRs of the splenic flexure (26.02% [96/369] vs. 16.04% [47/293], P < 0.05) and descending colon (20.86% [102/489] vs. 13.37% [54/404], P < 0.05) were significantly higher in deep-sedated colonoscopy than in unsedated colonoscopy when performed by middlelevel endoscopists rather than high-level endoscopists (P < 0.05).

CONCLUSIONS: AMR was higher in deep-sedated colonoscopy than in unsedated colonoscopy. Furthermore, adenomas in the splenic flexure and descending colon were more frequently missed in deep-sedated colonoscopy than in unsedated colonoscopy, particularly when performed by less experienced endoscopists.

END 

免责声明：

文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

—END—

编辑：Michel.米萱

校对：MiSuper.米超

打赏