Colonoscopy - What You Need to Know

Estimated reading time 7 minutes

10Life Team

29 Apr 2022
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10Life Team

29 Apr 2022

Estimated reading time 7 minutes

大腸癌是香港第二常見的癌症,如果及早發現並接受治療,五年存活率甚高,以第一期及第二期患者為例,分別達95.7%及87.3%。高危或出現常見徵狀人士應詢問醫生意見,有需要應進行內窺鏡(俗稱照腸鏡)等檢查,並應比較私家醫院/診所收費,以及了解自願醫保賠償細節。

乙狀結腸鏡 vs 結腸內視鏡(大腸鏡)

透過照腸鏡,可以切除瘜肉或異常組織,減低其變成癌症的風險。坊間泛稱的照腸鏡,其實可再細分兩種:乙狀結腸鏡和結腸內視鏡。如表1顯示,雖然兩款檢查過程相似,但不論檢查範圍、需時或價錢都不盡相同。讀者於選擇哪一款檢查之前,宜與醫生商討。

表1:乙狀結腸鏡和結腸內視鏡(大腸鏡)比較

乙狀結腸鏡
(Sigmoidoscopy)
結腸內視鏡
(大腸鏡,Colonoscopy)
檢查範圍 直腸和部分結腸 整條結腸及迴腸末端
檢查需時 約15分鐘 約1045分鐘
價錢 相對平宜 相對較高
檢查程序 •病者須向左側臥,雙膝向上屈曲。
• 為病人注射鎮靜劑和麻醉藥物。
•有先進儀器監察病人的血壓,心跳和血含氧量。
• 腸鏡由肛門進入。氣體會被打進腸內,以擴張大腸壁。
• 如病者腹部有脹迫感,或欲有排便的感覺,均屬正常。
• 如有需要,醫生會進行活組織檢取或治療,例如︰切除息肉、止血等。
• 會以錄像攝影記錄程序。
資料來源:綜合醫療機構資料

私家醫院或日間醫療中心腸鏡套餐價錢

照腸鏡可於私家醫院或門診進行。如果選揀日間治療,則不需留院過夜,價格會較平。消費者要留意,部份套餐價錢並不包括切除瘜肉、病理化驗等費用,而且有可能徵收其他額外雜費,故此預約服務前,應先向機療機構問清楚,以便制定預算。

表2:9間私家醫院或醫療中心腸鏡套餐價錢比較(日間治療,港元)

機療機構 結腸內視鏡檢查
播道醫院 $7,9001,2
高清腸胃內視鏡中心 $8,8001$13,0003(葵芳 / 觀塘 / 元朗)
$10,3001$17,0003(中環)
雅蘭高清腸胃內視鏡中心 $8,8001$13,8003
寶血醫院 (明愛) $9,0001,2
香港專科 $9,6001$15,4003
香港浸信會醫院 $10,1801,2
養和醫院 $10,4201,2
中大醫院 $10,6801$16,8604
港怡醫院 $12,100117,3004
註:
  1. 切除瘜肉須另行收費
  2. 病理化驗須另行收費。
  3. 包瘜肉及活組織抽取總數10粒或以上。
  4. 包切除息肉及/或活組織檢查 (數量>3)。

腸鏡一定可以Claim到保險?

一些舊款醫療保險未必涵蓋於門診進行的腸鏡,所以檢查前宜向保險公司查詢,確保相關項目是否屬保障範圍之內。

至於自願醫保計劃(VHIS),即使是入門級的標準計劃,我們預計可以涵蓋腸鏡檢查
(日間治療)78.2%開支,而一些更高階的自願醫保高端醫療保險,其相關預計保障率可以達100%不過大家必須留意等候期,歡迎讀者利用《產品解碼器》比較。(註1  

檢查前飲食準備:戒口清腸

檢查前,病人應向醫生了解原因、程序、可能發生之風險和併發症,並須告知醫生正在服食藥物,以及藥物敏感等個人醫療情況。在檢查前,醫生或會建議病人暫停服用指定藥物。

另外,戒口清腸有助清空腸道,使醫生更容易觀察大腸內部情況,是照腸鏡前的指定動作。不過,如於在服用瀉藥期間嘔吐、暈眩、虛脫等不適徵狀,便須立即停止服用,並告知醫護人員。

表3:照腸鏡事前準備

檢查前會診
向醫生了解檢查原因、程序、可能發生之風險和併發症,並將您的醫療情況告知醫生,包括︰

• 是否患有糖尿病、心臟病、高血壓、肺病等疾病。
• 服用藥物,特別是抗血小板或抗凝血藥物。
• 藥物敏感或其他過敏史。
• 體內有否裝有心臟起搏器或人工關節。
• 女士須留意最後月經日期,確保未有懷孕。
檢查前23天 只可進食低渣食物,避免高纖維食物,如蔬菜、水果。
檢查前1天 只可進食流質食物,例如稀粥水、肉汁。
檢查前1晚或當天 按醫生處方服食瀉藥。如在服用瀉藥期間出現嘔吐、暈眩、虛脫等不適徵狀,請立即停止服用,並告知醫護人員。
檢查前6小時 禁止飲食。
進行檢查前 須除去眼鏡、隱形眼鏡、飾物、金屬物品及假牙等。
資料來源:綜合醫療機構資料

可能出現之風險及併發症

照腸鏡雖然普遍,但並非全無風險,可能出現之風險及併發症包括:

  1. 鎮靜劑副作用,如: 血壓低、呼吸困難,甚至休克、昏迷。
  2. 因割除瘜肉而導致腸壁穿破。
  3. 抽取組織或割除瘜肉的地方可能出血。

檢查後5大注意事項

  1. 病人會有輕微腹部氣脹及頻頻放屁,但情況會漸漸回復正常。
  2. 待鎮靜劑藥物減退及詢問醫護人員後,才可進食。
  3. 由於病人曾接受麻醉或鎮靜藥物注射,如於 24 小時內離開,基於安全考慮,需由家人或親友陪同。
  4. 檢查後24小時內,避免駕駛車輛,操作重型器械或簽署重要文件。
  5. 進行切除息肉或組織檢取後一至兩天,病人或會發現大便有血,屬正常情況。不過,若然感到腹部劇痛、大量出血、發燒等,則須立即求醫。

腸鏡幾耐照一次好?

腸鏡並非一般身體檢查,毋須每年都做。即使是高風險人士(例如有很大、很多,或嚴重癌前病變的瘜肉),也只須每3年一次的大腸內窺鏡檢查。因此,檢查之前,讀者宜先諮詢醫生意見,了解是否有需要進行檢查。

至於介乎5075歲的「一般風險」人士,政府建議他們應與醫生商討,並考慮採取以下其中一種篩查方法:

  1. 每12年接受一次大便隱血測試;或
  2. 每5年接受一次乙狀結腸鏡檢查;或
  3. 每10年接受一次大腸鏡檢查。

註:
  1. 10Life根據多個常見、涉及不同程度、及醫療服務的傷病個案,於一般情況下的醫療開支,再由10Life精算師對照醫療產品的賠償上限,計算出來的預計平均保障,詳見《醫療保險的評分方法》。上述傷病個案的預計保障率是根據該傷病於一般情況下之預計醫療開支來計算,用作「預計」醫療保險及消費者大概要負擔的醫療開支,僅作參考之用,並未得到有關保險公司之確認。
  2. 本文最後更新日期: 2022年4月22日。

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YF Life Branch Manager

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