【精品】結(jié)腸鏡單人操作技術(shù)臨床應(yīng)用的探討

1、結(jié)腸鏡單人操作技術(shù)臨床應(yīng)用的探討真誠為您服務(wù)【摘要】 目的 探討結(jié)腸鏡單人操作技術(shù)的臨床應(yīng)用。方法 對2004年11月至2008年12月筆者采用結(jié)腸鏡單人操作技術(shù)施行全結(jié)腸檢查與治療的618例患者的資料進行回顧性分析。結(jié)果 結(jié)腸鏡單人操作檢查治療成功609例，成功率98.5%，回盲部到達率96.9%，末端回腸到達率55.5%;到達回盲部時間為550min，平均13 min;進鏡長度一般為5080cm,少數(shù)為80100cm，個別在100cm以上;行腸鏡下息肉切除(emrl)80例，腸鏡下行乙狀結(jié)腸套疊伴扭轉(zhuǎn)復(fù)位成功1例，無1例并發(fā)癥發(fā)生。結(jié)論 結(jié)腸鏡單人操作技術(shù)安全、簡便、成功率高，患者痛苦小，

2、值得臨床推廣。 【關(guān)鍵詞】 結(jié)腸鏡;單人操作abstract objective to investigate the clinical application of the technique of oneman colonoscopy. methods the data of 618 patients who were examined and treated with the technique of oneman colonoscopy from november 2004 to december 2008 were analyzed. results 609 patients wer

3、e successfully examined and treated with oneman colonoscopy, and the rate of success was 98.5%. the rate of reaching cecum was 96.9%, the rate of reaching the end of ileum was 55.5%. thirteen minutes on (average from five to fifty minutes) was used for reaching ileocecum. the length of the scope rea

4、ch to the cecum was commonly from fifty to eighty centimeters, minority were from eighty to one hundred centimeters, exceptionally over one hundred centimeters. polypectomy were performed in eighty cases and one case with sigmoid volvulus and intussusception was successfully treated by colonoscopy,

5、with no complications. conclusion oneman colonoscopy not only is safety, simple and convenient, but also has a high success rate and reduces patient pain, therefore is clinically worth popularizing.key words colonoscopy; oneman結(jié)腸鏡是檢查結(jié)直腸腸疾病可靠、有效的檢查方法,雙人操作曾是國內(nèi)外普遍采用的經(jīng)典方法, 自從日本消化內(nèi)鏡專家工藤進英創(chuàng)立“軸保持短縮法”以來,結(jié)腸鏡

6、單人操作技術(shù)日趨完美，因其操作安全、簡便、患者痛苦小、成功率高、患者反應(yīng)良好、又節(jié)省人力，已被發(fā)達國家廣泛采用，成為國際上結(jié)腸鏡插入法的主流技術(shù)，國內(nèi)僅有少數(shù)醫(yī)療單位和個人采用，遠未普及。筆者于2004年11月開始開展結(jié)腸鏡單人操作檢查與治療,至今完成618例次,無1例發(fā)生并發(fā)癥?，F(xiàn)將有關(guān)資料總結(jié)報告如下。1 資料和方法1.1 臨床資料 2004年11月至2008年12月采用結(jié)腸鏡單人操作法行全結(jié)腸檢查與治療的患者共618例次。其中男406例次,女212例次,年齡1689歲,平均41.5歲。臨床表現(xiàn)為腹痛、腹脹、腹瀉、便血、黏液便、黏液膿血便、便秘、腹部不適、腹部包塊等。其中有3例是直腸癌miles術(shù)后患者。1.2 腸道準(zhǔn)備 術(shù)前1 d低渣飲食,術(shù)前晚進流質(zhì),檢查當(dāng)日早8時予甘露醇500 ml和葡萄糖鹽水1000 ml口服，在2 h內(nèi)飲用完畢。少數(shù)腸道清潔不佳的患者給予清潔灌腸。對行息肉切除的患者采用硫酸鎂和口服補液鹽水作腸道準(zhǔn)備。1.3 操作方法 采用olympusgif260型電子結(jié)腸鏡進行操作?；颊呷∽髠?cè)臥位,術(shù)者左手持結(jié)腸鏡角度操作部,右手握住鏡身前端進鏡?；疽I(lǐng):根據(jù)結(jié)直腸走向協(xié)調(diào)內(nèi)鏡旋轉(zhuǎn)度與角