二氧化碳在常规结肠镜检查中的应用研究

Application of carbon dioxide to the conventional colonoscopy

目的：通过对常规结肠镜检查中注入空气与二氧化碳（CO2）气体的对比研究，探讨CO2的应用价值。方法连续纳入2014年1月至5月常规结肠镜检查患者681例，随机分为空气组和 CO2组，分别记录操作时间、气体流量、容量、PaCO2及肠镜检查中及结束20 min、40 min、1 h、2 h、12 h、24 h 的腹痛情况，对比分析 CO2在结肠镜检查中的安全性及优势。结果CO2组进镜时间明显低于空气组（P ＜0．05），退镜时间组间差异无统计学意义（P ＞0．05），组间气体流量和总容积差异无统计学意义（P ＞0．05）。2组患者 PaCO2均在正常范围之内，检查中 2组 PaCO2明显高于检查前及检查后20 min（P ＜0．05），但组间 PaCO2相比差异均无统计学意义（P ＞0．05）。检查中、结束后20 min、40 min、1 h、2 h，空气组腹痛评分明显高于 CO2组（P ＜0．05），结束后12 h 及24 h 腹痛评分组间差异无统计学意义（P ＞0．05）。结论CO2结肠镜检查中安全性高，可减少患者肠镜检查后腹部不适，适合在临床推广应用。

Objective To explore the application of CO2 as an insufflation agent in patients under-going colonoscopy by comparing carbon dioxide（CO2 ）and air.Methods Consecutive 681 patients who un-derwent conventional colonoscopy from January to May in 2014 at endoscopy center of our hospital were in-cluded.The patients were randomly divided into the air group and CO2 group.The gas flow,capacity,oper-ation time,PaCO2 and abdominal pain during and 20 min,40 min,1 h,2 h,12 h,24 h after colonoscopy were recorded.The safety and advantages of CO2 in the colonoscopy were analyzed.Results The intubation time of CO2 group was significantly shorter than that of air group （P〈0.05）,but there was no significant difference in endoscopy withdrawal time between the two groups （P〉0.05）.There was also no difference in air flow and the total volume between the two groups （P〉0.05）.PaCO2 of two groups were within the nor-mal range.PaCO2 during examination was significantly higher than that before and 20 minutes after examina-tion （P〈0.05）,but the PaCO2 between the two groups showed no significant difference （P〉0.05）.The abdominal pain scores during and 20 min,40 min,1 h,2 h after the examination of air group were signifi-cantly higher than those of CO2 group （P〈0.05）,but they were not 12h and 24h after the examination （P＆gt;0.05）.Conclusion CO2 is safe and could reduce abdominal discomfort after colonoscopy,which is suit-able for clinical application.