黑色先端帽联合窄带光成像在结肠镜检查中的作用

A randomized controlled trial evaluating the usefulness of a black hood attached to the tip of colonoscope with narrow band imaging for improvement of colorectal adenoma and polyp detection

摘要:

目的评估黑色先端帽辅助结肠镜联合窄带光成像（narrow band imaging,NBI）技术对腺瘤/息肉检出效能的影响。方法连续纳入2016年10月—2018年10月行结肠镜检查的患者，采用随机数字表法分为黑色先端帽组和对照组，黑色端帽组采用黑色先端帽辅助结肠镜联合NBI技术，对照组采用标准白光结肠镜，比较两组的息肉检出率、腺瘤检出率等指标，并进行亚组分析。结果共1 000例患者纳入本研究（每组500例），黑色先端帽组和对照组近端结肠腺瘤检出率分别为24.2%(121/500)和17.2%(86/500)，近端结肠息肉检出率分别为28.8%(144/500)和21.4%(107/500)，平均腺瘤检出数分别0.41±0.94和0.26±0.68,平均息肉检出数为0.63±1.16和0.40±0.85，差异均有统计学意义（P均<0.05），但该联合技术对于远端结直肠病变的检出率相较对照组无明显优势。结论黑色先端帽辅助结肠镜联合NBI能显著提高近端结肠腺瘤和息肉等微小病变的检出效能。

Abstract:

Objective To evaluate the usefulness of a black hood attached to the tip of colonoscope combined with narrow band imaging for detection efficiency of adenoma /polyp. Methods Consecutive patients referred for colonoscopy at our hospital between October 2016 and October 2018 were enrolled in the study and randomly divided into black hood group and control group. The two groups were assigned to black hood assisted colonoscopy with narrow band imaging and standard white light colonoscopy, respectively, of which adenoma and polyp detection rates were compared and subgroup analysis was conducted. Results A total of 1000 consecutive patients were enrolled in the study (500 patients in each group). In the black hood group, detection rate and average number of proximal colonic adenoma/polyp were both significantly higher than those in the standard white light colonoscopy with 7.0%/7.4% and 0.15/0.23 respectively (P<0.05). However, there were no significant differences in detection rate and average number of distal colorectal adenoma/polyp between two groups. Conclusion Black hood assisted colonoscopy with narrow band imaging can significantly improve detection efficiency of proximal colorectal adenoma/polyp. The combined technique has obvious advantages for detection of proximal colonic and minor lesions.