无痛结肠镜检查单人操作300例临床分析

Clinical Analysis of 300 Cases of Single Operation of Painless Colonoscopy

目的总结300例无痛结肠镜单人操作的临床经验。方法选取2009年12月—2011年6月在本院行无痛结肠镜检查的300例患者,采用芬太尼、丙泊酚注射液静脉复合麻醉,麻醉满意后单人操作下行无痛结肠镜检查,连续监测并记录检查前1～2 min、检查5 min、检查结束后1～2 min患者的脉搏血氧饱和度、心率、收缩压、舒张压等;同时记录操作时间、并发症情况及患者记忆消失率、满意率。结果 300例患者中,有290例进镜至回盲部,进镜成功率为96.6%;进镜60～80 cm即可到达回盲部,操作时间为10～30 min;均无穿孔、出血等并发症发生;记忆消失率为100%,满意率为98%;检查前、检查时、检查后脉搏血氧饱和度、心率、收缩压、舒张压比较,差异均无统计学意义(P>0.05)。结论无痛结肠镜检查单人操作安全有效,患者痛苦更小,易于接受,且对心血管功能影响小,值得临床推广应用。

Objective To summarize the clinical experiences of 300 cases of single operation of painless colonoscopy. Methods A total of 300 cases of painless colonoscopy between December 2009 and June 2011 were included in the study. Sin- gle operation of painless colonoseopy was conducted after compound anesthesia with fentanyl and propofol intravenous injection. Pulse oxygen saturation （SpO2 ）, heart rate （HR）, systolic blood pressure, and diastolic blood pressure were observed and re- corded I ~ 2 minutes before the operation, 5 rain after the start of the operation, and 1 ~ 2 minutes after the end of the operation. Operation time, complications, rate of memory loss, and satisfaction rate were also recorded. Results Among the 300 eases of colonoseopy, 290 cases succeeded in reaching ileocecal junction with success rate of 96. 6%. The course of 60 ~ 80 em to ileoce- cal junction took 10 ~ 30 minutes. No perforation, bleeding or other complications occurred. Memory disappearance rate was 100%, and satisfaction rate was 98%. No significant difference was observed in SpO2, HR, systolic blood pressure, and dias- tolic blood pressure before, during, and after the colonoscopy （ P 〉 0. 05 ）. Conclusion Single operation of painless colonos- copy is effective and safe with less pain and impact on cardiovascular function.