检验预防原则:一个范围审查,比较饮用水龙头和无菌水用于灌在结肠镜检查
Hilalion San Ahn1, Alexie Leclerc1, Jennifer Shamess1
1From the Department of Surgery, The Ottawa Hospital (Ahn, Moloo); Faculty of Medicine, University of Ottawa (Ahn, Leclerc, Moloo); Patient advisor (Shamess); Ottawa Hospital Research Institute (Pardo); Department of Gastroenterology, The Ottawa Hospital (Dube, Rostom, Calo); School of Epidemiology and Public Health (Thavorn); Departments of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa (McIsaac); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (McIsaac, Moloo); Department of Surgery, North York General Hospital, Toronto, Ont. (Smith).
龙头水可能是无菌水的安全和可持续替代品,用于结肠镜灌. 这次审查表明,饮用自来水提供了环境和经济的好处,没有报告的不良事件,支持其考虑.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 卫生政策 卫生政策
背景情况:
- 目前的结肠镜指南经常建议使用无菌水进行灌,基于其他内镜手术的有限证据.
- 人们对内镜灌水源的感染风险存在担忧.
- 使用无菌水对环境和经济的影响尚未被彻底评估.
研究的目的:
- 审查有关在结肠镜检查期间使用自来水与无菌水进行灌的现有证据.
- 评估不同灌水源对患者结果,医疗保健资源和环境的影响.
主要方法:
- 进行了全面的范围审查,包括在结肠镜检查中检查灌水源的所有研究类型.
- 从开始到2024年3月,主要数据库 (Embase,MEDLINE,CINAHL,Web of Science) 进行了搜索.
- 定量分析侧重于患者的结果,对资源和环境方面的定性综合.
主要成果:
- 包括三项前性研究 (1996-2002) 涉及137次结肠镜和38次灵活的半导体镜.
- 两项比较无菌水和自来水的研究显示,无菌水的阳性细菌培养较低 (6%对11%),但没有临床不良事件.
- 没有报告任何传染性并发症; 一项研究指出,与室温自来水相比,温水的患者疼痛得分较低.
结论:
- 目前,有限的证据支持在自来水和无菌水之间进行结肠镜灌的最终选择.
- 饮用自来水似乎是一个安全的选择,比无菌水提供了显著的环境和经济优势.
- 鉴于气候危机和医疗保健成本,可重复使用的瓶子中的自来水值得强烈考虑结肠镜灌.
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