...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Intestinal research. >Unsedated Colonoscopy and the Water Method for Minimizing Discomfort in the Unsedated Patients
【24h】

Unsedated Colonoscopy and the Water Method for Minimizing Discomfort in the Unsedated Patients

机译：未镇静的结肠镜检查和水疗法可最大程度地减少未镇静患者的不适

获取原文
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

A decade ago, failure of cecal intubation due to pain in ~20% of scheduled unsedated patients in the author's veterans practice prompted the search for a less uncomfortable approach. Methods that minimized discomfort or enhance cecal intubation included use of pediatric, variable stiffness, computer-assisted, 3-dimensional magnetic imaging colonoscope, gastroscope, and inhalation of nitrous oxide or insufflation of carbon dioxide; use of hypnosis, music, audio distraction, or simply allowing patients to participate in medication administration. In addition, several water-related techniques (as adjuncts to air insufflation) enhanced speed and success of intubation, reduced discomfort but did not appear to alter the amount of medications used. Because of simplicity, the water-related techniques added to turning off of the air pump were evaluated in a series of trial-and-error modifications. The result was the development of a water infusion in lieu of air insufflation method. Subsequent refinements included suction removal of all residual air to minimize angulations at flexures. Water exchange during insertion was used to suspend and removal feces to clear the luminal view while distention of the colonic lumen was minimize. Observational studies followed by randomized controlled trials confirmed the water method (simplified nomenclature) had significant impacts on discomfort both during and after colonoscopy: reduction of medication requirement; attenuation of insertion-related discomfort, enhancement of cecal intubation, decrease of pain after colonoscopy, increase in reported willingness to repeat unsedated colonoscopy in the patients examined without sedation and reduction of recovery time burden in patients accepting the option of sedation on demand.
机译：十年前，在作者的退伍军人实践中，约20％的预定镇静剂患者因疼痛而导致盲肠插管失败，促使人们寻求一种不太舒适的方法。减少不适或增强盲肠插管的方法包括：使用儿科，可变刚度，计算机辅助3维磁成像结肠镜，胃镜以及吸入一氧化二氮或吹入二氧化碳;使用催眠，音乐，听觉分散注意力，或干脆让患者参与药物管理。此外，几种与水有关的技术（作为空气吹入的辅助手段）提高了插管的速度和成功率，减少了不适感，但似乎并未改变所用药物的数量。由于简单性，经过一系列反复试验的评估，评估了关闭气泵时所使用的与水有关的技术。结果是开发了一种注水代替空气吹入法。随后的改进包括抽吸去除所有残留空气，以最大程度减少弯曲处的角度。插入过程中的水交换用于悬浮和清除粪便，以清除腔内的视线，同时最大程度地减少结肠腔的扩张。观察研究以及随后的随机对照试验证实，在结肠镜检查期间和之后，饮水方法（简化的术语）对不适感有显着影响：减少用药需求;减轻了与插入有关的不适，增强了盲肠插管，减少了结肠镜检查后的疼痛，增加了报道的在没有镇静的情况下接受无镇静结肠镜检查的患者重复无镇静结肠镜检查的意愿，并减少了接受按需镇静的患者的恢复时间负担。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号