肠道清洗对多胞体和腺瘤检测率的影响:随机临床试验的后期分析
Maida Marcello1,2, Vassallo Roberto3, Alessandro Vitello1,2
1Department of Medicine and Surgery, University of Enna 'Kore', 94100 Enna, Italy.
高质量的肠道制备在结肠镜检查过程中显著提高了聚检测率 (PDR) 和腺瘤检测率 (ADR). 然而,优秀的清洗并不能进一步提高这些率,突出了合规性和适当的ADR时间的重要性.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 结肠直肠癌查 结肠直肠癌查
背景情况:
- 肠道准备的质量对于结肠镜的有效性至关重要.
- 评估不同肠道清洁标准对多胞体和腺瘤检测的影响对于改善查结果很重要.
研究的目的:
- 评估肠道清洁质量如何影响多检测率 (PDR) 和腺瘤检测率 (ADR).
- 为了确定在结肠镜检查期间病变检测的预测因素.
主要方法:
- 一个多中心随机对照试验 (RCT) 的后期分析.
- 1L聚乙烯甘醇加上酸盐 (1L PEG+ASC) 与4L PEG用于肠道制备的比较.
- 使用波士顿肠道准备量表 (BBPS) 的评估.
主要成果:
- 与BBPS<6 (35.6%对18.5%) 相比,BBPS≥6的患者中,聚体检测率 (PDR) 显著更高.
- 腺瘤检测率 (ADR) 也较高 (25.6%与16.7%相比),但不显著.
- 在BBPS=9和BBPS=7-8.8之间没有观察到PDR或ADR的显著差异.
- 年龄较大,输管时间较短,戒药时间较长和第一剂量完全消耗独立地与ADR相关.
结论:
- 优秀的肠道清洁 (BBPS=9) 与高质量的清洁 (BBPS=7-8) 相比,并没有显著改善PDR或ADR.
- 清洗成功和准备类型不是ADR的独立预测因素.
- 患者遵守规定,结肠镜时间和停药时间对于足够的ADR至关重要,并可能减少间隔结肠直肠癌.
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