结肠镜检查中应用二氧化碳效果观察

Application of carbon dioxide in colonoscopy

目的探讨二氧化碳(CO2)用于结肠镜检查的效果及安全性。方法行结肠镜检查患者100例随机分为CO2组和空气组各50例,检查时分别注入CO2和空气,比较2组检查前、镜头达阑尾开口及检查结束时pa(CO2)水平,记录镜头到达阑尾开口及检查1、6、12h时腹痛、腹胀评分,检查后1h行腹部X线检查评定结肠膨胀程度评分。结果 2组镜头达阑尾开口及检查结束时pa(CO2)与检查开始前比较差异均无统计学意义(P>0.05);2组各时间点pa(CO2)比较差异均无统计学意义(P>0.05);CO2组检查前及检查1、6h腹痛评分[(2.43±0.22、2.22±0.21、1.34±0.18)分]、腹胀评分[(3.08±0.26、2.10±0.20、1.69±0.10)分]和检查后1h结肠膨胀程度评分[(2.42±0.14)分]均低于空气组[腹痛评分(4.60±0.53、3.50±0.39、2.52±0.33)分、腹胀评分(4.70±0.50、3.30±0.32、2.56±0.32)分、结肠膨胀程度评分(4.14±0.46)分](P<0.05)。结论与结肠镜检查中应用空气相比,应用CO2可减轻术中及术后腹痛、腹胀症状,且不增加CO2潴留。

Objective To evaluate the safety and effect of carbon dioxide （CO2） in colonoscopy. Methods A total of 100 patients undergoing colonoscopy were randomly divided into CO2 group injected with CO2 and air group injected with air, with 50 patients in each group. The changes of pa（CO2 ） were recorded at the time points of before examination, when the lens reached the appendix opening and at the end of examination, and were compared between two groups. The abdominal pain and distension were observed when the lens reached the appendix opening, and in 1, 6 and 12 hours after examination. Abdominal X-ray examination was performed 1 hour after examination to evaluate colon swelling degree. Results There was no significant difference in pa（CO2 ） between the time point of when the lens reached the appendix opening in comparison with the time point of after examination （P〉0.05）, and there were no significant differences in pa（CO2） values in all time points between two groups （P〉0.05）. Before examination, and 1- and 6-hour during examination, the abdominal pain scores were 2.43 ± 0.22, 2.22 ±0.21 and 1.34±0.18, abdominal distension score were 3.08±0.26, 2.10±0.20 and 1.69±0.10 in CO2 group, significantly lower than those in air group （4. 60±0. 53, 3.50±0.39, 2.52±0.33; 4.70±0.50, 3.30±0.32, 2.56±0.32） （P〈0.05）. And the colon swelling degree 1 hour after examination was significantly lower in CO2 group （2.42±0. 14） than that in air group （4. 14± 0.46） （P〈0.05）. Conclusion In comparison with air, CO2 used in colonoscopy can reduce the intraoperative and postoperative abdominal distension, abdominal pain, and does not increase the retention of CO2.