结肠镜|水辅助结肠镜的应用( 二 ) 结肠镜|结肠|结肠镜检查|回盲

Leung等总结了水辅助结肠镜检查法的操作要点：进镜前关闭注气通道；尽量吸引肠腔内残留的气体，尤其在直肠、脾曲及肝曲；镜身前端要紧贴近前方可疑肠管开口处注水；快速足量的注水，使前方肠管打开显现走行方向；尽量避免吸引黏膜；如果肠道准备不佳，尽量冲洗肠道，使视野逐渐清晰；当进镜顺利时，尽量吸出多余的水以减少肠管的扩张；要熟练鉴别水中浸泡的憩室、阑尾开口及在盲肠处吸引导致的红色印记；必要时应用压迫腹部、变换患者体位等技巧辅助寻腔进镜；退镜观察时，应尽量吸出残留的水，并注气使肠管充分扩张以观察。
水辅助结肠镜仍有很多方面值得改进，众多学者在结肠镜检查起始体位、注水时机、注水联合注入CO2气体或加戴透明帽辅助等方面正在进行积极的研究探索。相信改良后的水辅助结肠镜会有更广泛的应用前景。
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本文作者：王亚洲
作者单位：中部战区总医院消化内科
来源：中国医师协会内镜医师分会