Animal Experiment And Clinical Study With Different Temperature Water Infusion Of The Impact On Colonoscopy

Objective: Through animal experiments and clinical randomized controlled trial to assess different temperature water perfusion in intestinal mucosal tissue pathology and endoscopic operation, the influence of different gender, age, in different temperature water perfusion in patients with tolerance of differences. Methods:(1)Through animal experiment in different temperature water in intestinal mucosal damage degree, intraoperative vision exposed lumen, and identify the lumen osteotomies. Selected 30 average weight about 1.6-2.5 kg of regular grade, adult male rabbits, randomly assigned into different temperature group, the group A(35 ~ 36℃) and group B(37 ~ 38℃), group C(39 ~ 41℃). Performed by the same experimenter water retention enema, the intubation depth of about 15 cm from the anus, raise the hips keep 10 min single injection after colonoscopy. Operator is responsible for the determination of intraoperative intestinal mucosal changes and lumen vision exposure. Static air injection to be put to death animals, after caesarean section in 15 cm, 50 cm and 75 cm away from the anus bowel to each 2.0 x 3.0 cm specimens, fixed in 10% formalin, preparation of paraffin section. By senior pathologist according to Chiu’s scoring system, observation and evaluation of intestinal mucosa histopathological injury situation, take the different parts of the average score.(2) Collected in our hospital outpatient or hospitalization of anesthesia colonoscopy, have defecate difficulty, the first diagnosis of IBS, has a history of basin of abdominal surgery patients, according to the medical order.The people randomly divided into experimental group the waterflood colonoscopy group, and control the gas injection colonoscopy. The experimental group were randomly divided into: group A, 38 water injection ℃into the lens group; group B, 39 water injection into th℃ e lens group; group C, 40 water injection into the lens group℃,and group D, 41 water injection into ℃the lens. Observation indexes: cecal intubation rate,cecal intubation time, the operator satisfaction,water injection volume,polyps detection rate,abdominal pain score,willingness to re-examine, intraoperative position transformation and abdominal pressure required for usage and adverse events. At the same time, according to each patient, subjective feeling of endoscopic check reference pain visual analog scale(VAS) appraise the degree of abdominal pain and willing to accept the review.(3)This study will also be the experimental group according to gender, age group, respectively, to explore different temperature water infusion colonoscopy tolerance of patients with different gender and age differences. Men VS women, youth(18 ~ 44) VS middle-aged(45-64 years) VS elderly(65 ~ 80 years). Results:(1) Through animal experiments prove the three sets of temperature on intestinal mucosal tissue pathology has no obvious injury(P = 0.930), but the group C(39 ~ 41 ℃) injection into the mirror method insufflate stretch and lumen vision best exposure effect(P < 0.05);(2)Clinical randomized controlled trial of 200 patients completed surveys, neither bowel perforation and other complications occurred. Experimental group success rate of the whole colon examination, cecal intubation time, the operator satisfaction and check again wishes were significantly higher than that of control group(P < 0.05). In abdominal pressure and utilization, abdominal pain scoring position transformation, the former was significantly lower than the latter(P < 0.05). Two groups of polyp detection rate and no statistical difference(P = 0.544);(3) In the clinical trial results show that the experimental group A, B, C, D four groups in success rate, water injection and abdominal pressure, position transformation and polyp detection rate has no significant difference(P > 0.05); the cecal intubation time of group C was the shortest(P < 0.05), the operator’s satisfaction, patient tolerance level(including abdominal pain score and check again intend) was significantly lower than A, B, D group(P < 0.05);(4) Clinical studies have shown that the elderly and women with tolerance were significantly higher than in group C, D, A, B group(P < 0.05), where D group is significantly higher than C group(P < 0.05). Conclusion:Warm water infusion can significantly increase the colonoscopy intubation success rate, shorten the mirror process, improve work efficiency. Among them, 40 is the ideal temperature, 41 is also the ideal ℃ ℃temperature, visual client to gender, age and choice.