[1]李夏薇李龙钦**王华秀陈丽玲.醋酸-靛胭脂染色结肠镜与注水结肠镜对近端结肠腺瘤检出率的随机对照研究[J].中国微创外科杂志,2026,01(4):193-198.
　Li Xiawei,Li Longqin,Wang Huaxiu,et al.Proximal Colon Adenoma Detection Rate Between Acetic Acidindigo Carmine Chromoendoscopy and Water Perfusion Colonoscopy：a Randomized Controlled Study[J].Chinese Journal of Minimally Invasive Surgery,2026,01(4):193-198.
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醋酸-靛胭脂染色结肠镜与注水结肠镜对近端结肠腺瘤检出率的随机对照研究()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2026年4期
页码:
193-198
栏目:
临床论著
出版日期:
2026-04-24

文章信息/Info

Title:
Proximal Colon Adenoma Detection Rate Between Acetic Acidindigo Carmine Chromoendoscopy and Water Perfusion Colonoscopy：a Randomized Controlled Study
作者:
李夏薇李龙钦**王华秀陈丽玲
(晋江市医院上海市第六人民医院福建医院消化内科，晋江362200)
Author(s):
Li Xiawei;  Li Longqin;  Wang Huaxiu;  et al.
Department of Gastroenterology, Jinjiang Municipal Hospital, Shanghai Sixth People’s Hospital Fujian, Jinjiang 362200, China
关键词:
注水结肠镜; 醋酸-靛胭脂染色结肠镜; 近端结肠; 腺瘤检出率
Keywords:
Water perfusion colonoscopy; Acetic acidindigo carmine chromoendoscopy; Proximal colon; Adenoma detection rate
文献标志码:
A
摘要:
目的探讨醋酸-靛胭脂染色结肠镜与注水结肠镜对近端结肠腺瘤检出率(adenoma detection rate，ADR)的差异。方法前瞻性纳入2024年1月~2025年5月肠镜检查218例，随机分为染色组(醋酸-靛胭脂染色结肠镜组，n=109)和注水组(注水结肠镜组，n=109)。2组均在麻醉医师监护下采用丙泊酚联合芬太尼静脉镇静镇痛，按常规结肠镜进镜至回盲部，螺旋式退镜至肛门口，退镜时染色组以醋酸-靛胭脂溶液灌洗，注水组以生理盐水灌洗。记录近端结肠(包括升结肠和横结肠)ADR及无蒂锯齿状病变检出率，同时评估检查后相关不良反应及患者满意度。结果染色组升结肠ADR［12.8%(14/109)］显著高于注水组［4.6%(5/109)］(P=0.031)，横结肠及总的近端结肠ADR虽高于注水组，但差异无显著性［横结肠9.2%(10/109)vs.4.6%(5/109)，P=0.181；近端结肠17.4%(19/109)vs.9.2%(10/109)，P=0.073］。染色组近端结肠锯齿状病变检出率［9.2%(10/109)］显著高于注水组［2.8%(3/109)］(P=0.045)。染色组总不良反应发生率显著低于注水组［17.4%(19/109)vs.31.2%(34/109)，P=0.018］，患者总满意率显著高于注水组［99.1%(108/109)vs.92.7%(101/109)，P=0.041］。结论与注水结肠镜相比，醋酸-靛胭脂染色结肠镜可以显著提高近端结肠腺瘤及无蒂锯齿状病变的检出率，且安全性良好，患者满意度高。
Abstract:
ObjectiveTo investigate the difference of the proximal colon adenoma detection rate (ADR) between acetic acidindigo carmine chromoendoscopy and water perfusion colonoscopy.MethodsA total of 218 patients undergoing colonoscopy from January 2024 to May 2025 were prospectively enrolled and randomly divided into the chromoendoscopy group (acetic acidindigo carmine chromoendoscopy group, n=109) and the water perfusion group (water perfusion colonoscopy group, n=109). Under the supervision of anesthesiologists, both groups were given intravenous sedation and analgesia with propofol combined with fentanyl. They underwent conventional colonoscopy, advancing to the cecum and withdrawing in a spiral manner to the anal verge. During withdrawal, the chromoendoscopy group was irrigated with acetic acidindigo carmine mixture, while the water perfusion group was irrigated with saline. The ADR of the proximal colon (including the ascending colon and transverse colon) and the detection rate of sessile serrated lesions were recorded. Additionally, postprocedure adverse reactions and patient satisfaction were assessed.ResultsThe ADR of the ascending colon in the chromoendoscopy group was 12.8% (14/109), which was significantly higher than that in the water perfusion group ［4.6% (5/109), P=0.031］. Although the ADR of the transverse colon and the total proximal colon in the chromoendoscopy group were higher than those in the water perfusion group, the differences were not statistically significant ［transverse colon: 9.2% (10/109) vs. 4.6% (5/109), P=0.181; proximal colon: 17.4% (19/109) vs. 9.2% (10/109), P=0.073］. The detection rate of sessile serrated lesions in the proximal colon of the chromoendoscopy group was 9.2% (10/109), significantly higher than that in the water perfusion group ［2.8% (3/109), P=0.045］. The overall incidence of adverse reactions in the chromoendoscopy group was significantly lower than that in the water perfusion group ［17.4% (19/109) vs. 31.2% (34/109), P=0.018］, and the overall patient satisfaction rate in the chromoendoscopy group was significantly higher than that in the water perfusion group ［99.1% (108/109) vs. 92.7% (101/109), P=0.041］.ConclusionCompared with waterinjection colonoscopy, acetic acidindigo carmine chromoendoscopy significantly improves the detection rates of proximal colon adenomas and sessile serrated lesions, demonstrating favorable safety and high patient satisfaction.

参考文献/References:

[1]赵优冬,柏愚.2022年中国结直肠癌发病与死亡特征分析.海军军医大学学报,2025,46(1):48-52.
[2]Alrushaid N,Khan FA,AlSuhaimi E,et al.Progress and perspectives in colon cancer pathology,diagnosis,and treatments. Diseases,2023,11(4):148.
[3]赵胜兵,宋铱航,贺子轩,等.结肠镜检查退镜时间对结直肠息肉检出影响的研究现状.结直肠肛门外科,2021,27(6):531-535.
[4]Cooper GS,Xu F,Barnholtz Sloan JS,et al.Prevalence and predictors of interval colorectal cancers in medicare beneficiaries.Cancer,2012,118(12):3044-3052.
[5]叶国良,胡柯峰.高质量结肠镜检查的实施途径研究进展.浙江医学,2025,47(1):1-8.
[6]张元瑞,汤胜君,钱立康,等.注水式结肠镜与注气式结肠镜在临床应用中的对照研究.临床内科杂志,2023,40(8):565-566.
[7]Kinugasa H,Hiraoka S,Kobayashi S,et al.Acetic acidindigo carmine chromocolonoscopy for proximal serrated lesions:a randomized,3arm colonoscopy study.Am J Gastroenterol,2025,120(12):2877-2888.
[8]陆军平,李煜熙,刘秋贤,等.醋酸靛胭脂混合三明治染色法联合智能分光比色技术结肠镜下Pit pattern分型对结直肠病变的诊断价值.中国内镜杂志,2024,30(9):61-70.
[9]王伟强,鹿志军.不同地域结直肠腺瘤检出率及其高危因素对比分析.中国肿瘤临床,2017,44(21):1090-1094.
[10]上海国家消化系统疾病临床医学研究中心,国家消化道早癌防治中心联盟,中华医学会消化内镜学分会,等.中国早期结直肠癌筛查流程专家共识意见(2019,上海).中华消化内镜杂志,2019,36(10):709-719.
[11]Rex DK,Anderson JC,Butterly LF,et al.Quality indicators for colonoscopy.Gastrointest Endosc,2024,100(3):352-381.
[12]中华医学会消化内镜学分会结直肠学组.结肠镜检查肠道准备专家共识意见(2023，广州).中华消化内镜杂志,2023,40(6):421-430.
[13]刘涛,邓海骏,余小渔,等.消化内镜诊疗满意度量表的编制及评价.中南大学学报(医学版),2023,48(6):859-867.
[14]Brenner H,Kloor M,Pox CP.Colorectal cancer.Lancet,2014,383(9927):1490-1502.
[15]East JE,Atkin WS,Bateman AC,et al.British Society of Gastroenterology position statement on serrated polyps in the colon and rectum.Gut,2017,66(7):1181-1196.
[16]Emmanuel A,Williams S,Gulati S,et al.Incidence of microscopic residual adenoma after complete widefield endoscopic resection of large colorectal lesions:evidence for a mechanism of recurrence.Gastrointest Endosc,2021,94(2):368-375.
[17]Brown SR,Baraza W,Din S,et al.Chromoscopy versus conventional endoscopy for the detection of polyps in the colon and rectum.Cochrane Database Syst Rev,2016,4(4):CD6439.
[18]Pohl J,Schneider A,Vogell H,et al.Pancolonic chromoendoscopy with indigo carmine versus standard colonoscopy for detection of neoplastic lesions:a randomised twocentre trial.Gut,2011,60(4):485-490.
[19]Hong SM,Kim GH,Lee BE,et al.Association between mucin phenotype and lesion border detection using acetic acidindigo carmine chromoendoscopy in early gastric cancers.Surg Endosc,2022,36(5):3183-3191.
[20]Rabago LR,Delgado Galan M.Precision in detecting colon lesions:a key to effective screening policy but will it improve overall outcomes?World J Gastrointest Endosc,2024,16(3):102-107.
[21]Winawer SJ,Zauber AG,Ho MN,et al.Prevention of colorectal cancer by colonoscopic polypectomy.The National Polyp Study Workgroup.N Engl J Med,1993,329(27):1977-1981.

备注/Memo

备注/Memo:
基金项目：晋江市医院(上海市第六人民医院福建医院)院级课题(2023LC05)**通讯作者，Email：309748275@qq.com
更新日期/Last Update: 2026-04-24