Clinical impact of endoscopy position detecting unit (UPD-3) for a non-sedated colonoscopy
Clinical impact of endoscopy position detecting unit (UPD-3) for a non-sedated colonoscopy
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DOI：
10.3748/wjg.v21.i16.4903
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发表时间：
2015-04-28
影响因子：
4.3
通讯作者：
Moriyasu, Fuminori
中科院分区：
文献类型：
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作者：
Fukuzawa, Masakatsu;Uematsu, Junichi;Moriyasu, Fuminori
目的：评估内窥镜位置检测装置（UPD-3）是否可以提高盲肠插管率、盲肠插管时间和视觉模拟量表（VAS）疼痛评分，无论结肠镜医生的经验水平如何。 方法：总共 260 名接受结肠镜检查的患者（170 名男性和 90 名女性）分为 UPD-3 引导组或常规组（无 UPD-3 指导）。结肠镜检查由专家（超过1000例结肠镜检查经验）或实习生（少于100例结肠镜检查经验）进行。评估盲肠插管率、盲肠插管次数、插入方法（直插：通过弯曲技术缩短结肠皱襞；绳索插入：右转缩短技术）和患者不适。通过VAS对患者内窥镜插入过程中的不适程度进行评分，将疼痛分为6级。结果：传统组和UPD-3引导组的盲肠插管率、盲肠插管次数、<15 min内进行的盲肠插管次数和插入方法没有显着差异。在 UPD-3 引导组中，在插入过程中出现疼痛的患者数量明显少于传统组。单变量和多变量分析显示，以下因素与内窥镜插入时较低的VAS疼痛评分相关：插入方法（直插入）和受训者组的UPD-3指导。对于专家组来说，单变量分析显示，只有插入方法（直接插入）与较低的 VAS 疼痛评分相关。 结论：虽然 UPD-3 指导并没有缩短插管时间，但与传统内窥镜检查相比，与受训者执行的手术相比，它可以减少内窥镜插入过程中患者的疼痛。
AIM: To evaluate whether an endoscopy position detecting unit (UPD-3) can improve cecal intubation rates, cecal intubation times and visual analog scale (VAS) pain scores, regardless of the colonoscopist's level of experience.METHODS: A total of 260 patients (170 men and 90 women) who underwent a colonoscopy were divided into the UPD-3-guided group or the conventional group (no UPD-3 guidance). Colonoscopies were performed by experts (experience of more than 1000 colonoscopies) or trainees (experience of less than 100 colonoscopies). Cecal intubation rates, cecal intubation times, insertion methods (straight insertion: shortening the colonic fold through the bending technique; roping insertion: right turn shortening technique) and patient discomfort were assessed. Patient discomfort during the endoscope insertion was scored by the VAS that was divided into 6 degrees of pain.RESULTS: The cecum intubation rates, cecal intubation times, number of cecal intubations that were performed in < 15 min and insertion methods were not significantly different between the conventional group and the UPD-3-guided group. The number of patients who experienced pain during the insertion was markedly less in the UPD-3-guided group than in the conventional group. Univariate and multivariate analysis showed that the following factors were associated with lower VAS pain scores during endoscope insertion: insertion method (straight insertion) and UPD-3 guidance in the trainee group. For the experts group, univariate analysis showed that only the insertion method (straight insertion) was associated with lower VAS pain scores.CONCLUSION: Although UPD-3 guidance did not shorten intubation times, it resulted in less patient pain during endoscope insertion compared with conventional endoscopy for the procedures performed by trainees.