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目的探讨透明帽及人工智能染色(FICE)技术应用于结肠镜检查对降低息肉漏诊率的作用。方法对愿意接受同次两遍“串联式”肠镜检查的150例患者进行前瞻性随机对照研究,将符合纳入标准的患者随机分入A组(透明帽→常规组)、B组(FICE→常规组)、C组(常规→常规组)3组,每组各50例,每组均由高资质的同一医师一次性完成,记录各组的息肉漏诊情况、第一遍肠镜检查所需时间及不良事件发生情况。结果 A、B、C组息肉患者漏诊率分别为12%、36%、34%,患者息肉漏诊率分别为12.2%、29.4%、29.2%,差异有统计学意义(P<0.05),进一步两两比较后提示透明帽可降低息肉患者漏诊率和患者息肉漏诊率(P<0.05);但各组漏诊息肉的大小、部位、山田分型、病理类型差异无统计学意义(P>0.05)。A、B、C组的进镜时间(s)分别为263.22±92.06、312.10±103.15、304.84±109.87,透明帽辅助组所需进镜时间最短(P<0.05)。各组的不良事件发生率差异无统计学意义(P>0.05)。结论尚不能证实FICE技术能降低息肉漏诊率;透明帽辅助能降低息肉漏诊率,缩短进镜时间,节约肠镜检查的时间成本,安全性高。
Objective To investigate the effect of transparent cap and artificial intelligence staining (FICE) technique on colonoscopy in reducing the rate of misdiagnosis of polyps. Methods A prospective randomized controlled study was conducted in 150 patients who were willing to receive the same double-pass “in-line” colonoscopy. Patients who met the inclusion criteria were randomly divided into group A (transparent cap → conventional group), group B ( FICE → conventional group), group C (conventional group), and group C (n = 50). Each group was completed by one highly qualified physician at the same time. The history of polyp misdiagnosis in each group was recorded. The time required and the occurrence of adverse events. Results The misdiagnosis rates of patients with polyps were 12%, 36%, 34% respectively in patients with A, B, C, and 12.2%, 29.4%, 29.2% respectively in patients with polyp. The differences were statistically significant (P <0.05) The transparent cap was suggested to reduce the rate of misdiagnosis and the rate of misdiagnosis of polyp (P <0.05). However, there was no significant difference in the size, site, type and pathological type of polyps misdiagnosed in each group (P> 0.05). A, B, C group into the mirror time (s) were 263.22 ± 92.06,312.10 ± 103.15,304.84 ± 109.87, the transparent cap hatch group into the mirror the shortest time (P <0.05). The incidence of adverse events in each group had no significant difference (P> 0.05). Conclusions FICE can not confirm the low rate of polyps misdiagnosis. Transparent cap can reduce the rate of polyps misdiagnosis, shorten the time of entering the mirror, save the time cost of colonoscopy, and have high safety.