以空气为介质的CT仿真小肠镜不同注气量检查效果及安全性分析

Effect and safety of computed tomographic enteroclysis with air with different air injection volume

目的分析以空气为介质的CT仿真小肠镜不同注气量检查效果及安全性。方法纳入首都医科大学附属北京安贞医院和首都医科大学附属北京朝阳医院2013年1月至2015年6月行以空气为介质的CT仿真小肠镜检查的患者47例，完全随机分为1．2L组（12例）、1．5L组（12例）、1．8L组（12例）和2．0L组（11例），相应给予不同空气注气量。观察小肠充盈程度、患者不适程度及不良反应发生情况。结果小肠充盈程度4组比较差异有统计学意义[1．2L组：1分2例、2分6例、3分4例；1．5L组：2分2例、3分7例、4分3例；1．8L组：2分1例、3分3例、4分8例；2．0L组：2分1例、3分3例、4分7例]（P〈0．01），两两比较1．8L组及2．0L组小肠充盈程度优于1.2L组（P〈0．01）。4组患者不适程度差异无统计学意义（P〉0．05）。发生腹胀1．2L组2例、1．5L组3例、1．8L组3例、2．0L组5例；发生恶心1．5L组1例、1．8L组2例、2．0L组3例。结论以空气为介质的CT仿真小肠镜在安全注气量范围内，注气量越多，小肠充盈程度越好，不良反应亦明显增加，应根据检查需要和患者的反应选择合适的注气量。

Objective To analyze the effect and safety of computed tomographic enteroclysis with air with different air injection volume. Methods Totally 47 patients undergoing computed tomographic enteroclysis with air from January 2013 to June 2015 were randomly divided into 1.2 L group（ 12 cases）, 1.5 L group （ 12 cases）, 1.8 L group （ 12 cases） and 2.0 L group （ 11 cases） given different air injection volume. The filling degree of small intestine, patient discomfort degree and incidence of adverse reactions were compared between groups. Results The filling degree of small intestine was significantly different among 4 groups E 1.2 L group ： 2 cases of 1 score, 6 cases of 2 scores, 4 cases of 3 scores; 1.5 L group： 2 cases of 2 scores, 7 cases of 3 scores, 3 cases of 4 scores; 1.8 L group： 1 ease of 2 scores, 3 cases of 3 scores, 8 cases of 4 scores; 2.0 L group： 1 case of 2 scores, 3 cases of 3 scores, 7 cases of 4 scores] （P 〈 0. O1 ） ; the filling degrees of small intestine in 1.8 L group and 2. 0 L group were significantly better than that in 1.2 L group （ P 〈 0. 01 ）. The patient discomfort degree was not significantly different among 4 groups （ P 〉 0. 05 ）. The abdomianl distention occurred in 2 cases in 1.2 L group, 3 cases in 1.5 L group, 3 cases in 1.8 L group and 5 cases （45.5%） in 2. 0 L group; the nausea occurred in 1 case in 1.5 L group, 2 cases in 1.8 L group and 3 cases in 2.0 L group. Conclusion In computed tomographic enteroclysis with air, the small intestine filling degree gets better with increasing of air injection volume, but the incidence of adverse reactions is also increased; suitable air injection volume should be chosen according to the needs and patients＇ response.