在初学者内镜师中评估水辅助结肠镜检查:一种随机对照试验
Nuttida Manoros1, Nithi Thinrungroj2, Wasuwit Wanchaitanawong3
1Division of Gastroenterology, Department of Medicine, Chiang Mai University, Chiang Mai, Thailand.
水辅助结肠镜 (WAC) 对于初学者内镜师来说,与传统的二氧化碳结肠镜 (CC) 一样安全有效. 这两种方法都显示了类似的程序时间,安全性和学习曲线,支持WAC在培训中.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 医学培训 医学培训 医学培训
背景情况:
- 结肠镜是关键的诊断工具,但其学习曲线对初学者内镜师来说可能具有挑战性.
- 传统的二氧化碳 (CC) 吸入是标准的,但使用水浸泡技术的水辅助结肠镜 (WAC) 是一种新兴的替代方案.
- 优化培训方法对于提高结肠镜检查能力和患者的治疗结果至关重要.
研究的目的:
- 为了比较水辅助结肠镜 (WAC) 与常规二氧化碳结肠镜 (CC) 的疗效和安全性,在初学者内镜师中.
- 评估手术时间,学习曲线和患者报告的WAC和CC之间的结果.
- 确定WAC是否是胃肠病学培训计划的可行替代方案.
主要方法:
- 一个前性,随机的 (1:1) 单中心试验,涉及6名胃肠病学研究员,他们之前做过的结肠镜检查不到150次.
- 在WAC和CC技术方面提供了标准化的培训.
- 患者被随机分配到使用WAC或CC进行查结肠镜检查,首要结局是内输液时间 (CIT).
主要成果:
- 在WAC (10.6±4.2分钟) 和CC (9.8±3.9分钟) 组 (p=0.35) 中,毛囊输液时间 (CIT) 的平均值相似.
- 技术失败率 (6.2%WAC与5.1%CC),程序难度,止痛药要求和患者不适得分在两组之间是相似的.
- 腺瘤检测率 (ADR) 也相似 (40.7%的WAC与33.3%的CC相比;p=0.25),学习曲线显示了两种技术在CIT的平行改进.
结论:
- 水辅助结肠镜 (WAC) 为新手内镜师提供了传统二氧化碳结肠镜 (CC) 的安全有效替代方案.
- 与CC相比,WAC表现出类似的程序时间,学习曲线和安全配置文件.
- 这些发现倡导将WAC纳入胃肠病学培训课程,以加强内镜技能的学习.
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