结肠CT仿真内窥镜充气方法及压力的研究

Colonic CT virtual endoscopy: research of the methods and atmospheric pressure for colon insufflation

目的:探讨结肠CT仿真内窥镜较理想的充气方法和充气压力。材料和方法:8名志愿者中,男4名,女4名,最大年龄50岁,最小年龄40岁,平均44.4岁。用电脑遥控灌肠整复仪通过双腔气囊胶乳导尿管向志愿者结肠内注入气体。先行最大耐受气压CT扫描,扫描期间持续注入这个压力直到扫描结束,然后每降低7.5mmHg进行一次CT扫描,最低压力为30mmHg。结果:肛门插管用双腔气囊胶乳导尿管。CT扫描时,用持续性注入同一压力气体的方法。结肠扩张程度,在52.5mmHg,40mmHg,37.5mmHg,30mmHg4个级别气压之间,无显著性差异。结肠充气CT扫描后,腹部不适消失时间,男女之间有显著性差异。结论:CT扫描时,持续性注入同一压力气体的方法,可以保持肠管扩张的稳定性,保证CTVE检查的顺利进行。肠管充气压力的控制,不应以患者的最大耐受为标准,应以较低的气压为妥,本研究为30mmHg。肛门插管用双腔气囊胶乳导尿管,其膨胀的气囊可以起到固定导尿管和减少导尿管与肛门间的漏气作用。CT充气扫描后,腹部不适消失时间,女性较男性为长。

Objective： To explore the optimal methods and pressure for colon insufflation in computed tomographic colonography. Material and Methods： Eight volunteers（4 men, 4 women; mean age, 44.4 years; range, 40-50 years）. Insufflation of the colon was performed using the machine（Compute Remote Controlling Enema Taxis Instrument） through catheter（double channel Foley balloon indwelling latex catheter）. When people underwent CT colonography, we choose the highest pressure which did not cause undue people discomfort for the beginning pressure. We should hold the pressure until finishing the scanning. Then we reduced pressure for the other scanning. We reduced 7.5mmHg per time until the pressure is 30mmHg. Results： Double channel Foley balloon indwelling latex catheter is placed in the rectum. During scanning, air was insufflated under the same pressure which was kept to the end. Under different atmospheric pressure： 52.5mmHg, 40mmHg, 37.5mmHg, 30mmHg. The distensibility of colon did not have obvious difference. After scanning, the time when the discomfort of abdomen disappeared was obvious difference between the men＇s and the women＇s. Conclusions： During scanning, air was insufflated under the pressure which was hold to the end. The method can hold the stability of colon＇s distensibility, and it make sure that the examination of CTVE is successful, The pressure of colon insufflation should not be according to the patient maximum tolerance. The pressure we chose was 30mmHg. We placed double channel Foley balloon indwelling latex catheter in the rectum. The gas bag of catheter can prevent the catheter from dislodging and reduce the air which went out between catheter and anus. After scanning, the time when the discomfort of abdomen disappeared was different. The women＇s is longer than the men＇ s.