二氧化碳注入联合水交换在肠镜检查中的应用效果分析
摘要
目的探究二氧化碳注入联合水交换在肠镜检查中的应用效果。方法选择2018年2至11月新疆军区总医院北京路临床部拟行结肠镜检查的患者190例,随机分为空气组(63例)、水交换组(63例)和联合组(64例)。空气组患者采用常规注气结肠镜检查;水交换组患者采用注水结肠镜检查;联合组患者采用二氧化碳气泵联合注水结肠镜检查。比较三组的结肠镜检查情况、检查后不适症状间的差异。结果水交换组和联合组的退镜时间和麻醉需求率均显著低于空气组,两组的盲插成功率和Boston评分均明显高于空气组(P <0. 05);联合组的退镜时间明显低于水交换组,差异均有统计学意义(P <0. 05)。三组的进镜时间和检出率间均无统计学差异(P>0. 05)。水交换组、联合组检查中及检查后1 h的VAS评分和腹胀评分显著低于空气组(P <0. 05)。检查中,联合组的VAS评分低于水交换组(P <0. 05),两组的腹胀评分比较无统计学差异(P> 0. 05);检查后1 h,联合组的VAS评分和腹胀评分均显著低于水交换组(P <0. 05)。结论二氧化碳注入联合水交换可明显减少退镜时间和麻醉需求,有效改善清洁度,减轻患者的疼痛和腹胀程度。
引文
[1]Pan J,Xin L,Ma YF,et al.Colonoscopy Reduces Colorectal Cancer Incidence and Mortality in Patients With Non-Malignant Findings:A Meta-Analysis[J].Am J Gastroenterol,2016,111(3):355-365.
[2]赖华生,林志昭,孟琰,等.结直肠癌早期筛查技术研究进展[J].现代消化及介入诊疗,2017,22(5):752-756.
[3]Ekkelenkamp VE,Dowler K,Valori RM,et al.Patient comfort and quality in colonoscopy[J].World J Gastroenterol,2013,19(15):2355-2361.
[4]Cadoni S,Sanna S,Gallittu P,et al.A randomized,controlled trial comparing real-time insertion pain during colonoscopy confirmed water exchange to be superior to water immersion in enhancing patient comfort[J].Gastrointest Endosc,2015,81(3):557-566.
[5]Lynch I,Hayes A,Buffum MD,et al.Insufflation using carbon dioxide versus room air during colonoscopy:comparison of patient comfort,recovery time,and nursing resources[J].Gastroenterol Nurs,2015,38(3):211-217.
[6]Mc Commons R,Wheeler M,Houston S.Colonoscopy Comfort:An Evidence-Based Practice Project[J].Gastroenterol Nurs,2016,39(3):212-215.
[7]蒋玉立.社区大肠癌高危人群肠镜检查依从性的意愿及影响因素分析[J].中国初级卫生保健,2017,31(8):10-12.
[8]杨成,项立,赵新华,等.结肠镜退镜时间的研究现状及思考[J].中华消化内镜杂志,2016,33(8):512-513.
[9]Leung FW,Jia H.Expert endorsement,a prerequisite to general acceptance,marked a significant milestone in the history of water exchange colonoscopy[J].Gastrointest Endosc,2018,88(4):598-600.
[10]Ojidu H,Palmer H,Lewandowski J,et al.Patient tolerance and acceptance of different colonic imaging modalities:an observational cohort study[J].Eur J Gastroenterol Hepatol,2018,30(5):520-525.
[11]张荣,田叶红,张利云,等.注水法在结肠镜检查中的应用价值[J].山西医科大学学报,2016,47(1):71-74.
[12]陈桂权,詹磊磊,刘宇虎,等.注水式结肠镜在肠镜检查中的应用体会[J].中国内镜杂志,2015,21(12):1252-1256.
[13]王薇,薄禄龙,邓小明.二氧化碳充气在妇科术后无痛结肠镜检中的安全性研究[J].国际麻醉学与复苏杂志,2016,37(9):786-789.
[14]张海燕,谭婧宇,梁玲,等.重庆地区结直肠癌高危人群结直肠镜免费筛查的依从性及影响因素研究[J].重庆医科大学学报,2016,41(12):1263-1267.
[15]陈佩松,马镇坚,张洪实,等.老年患者结肠镜检查肠道准备不良的影响因素分析[J].现代消化及介入诊疗,2017,22(3):358-360.
[16]Feisthammel J,Vu TK,Hollenbach M,et al.Is CO2 insufflation an amelioration of routine colonoscopy?[J].Minerva Gastroenterol Dietol,2018,64(3):193-200.
[17]俞海洋,万元春,王金婷,等.安装透明帽并二氧化碳气体注入对结肠镜检查进镜速度及结肠息肉检出率的影响[J].中国内镜杂志,2017,23(8):81-85.
[18]杜志强,徐文革,张静,等.水交换结肠镜结合二氧化碳注气行结肠镜检查的临床分析[J].中华结直肠疾病电子杂志,2016,5(2):163-166.
[19]Cadoni S,Falt P,Gallittu P,et al.Impact of carbon dioxide insufflation and water exchange on postcolonoscopy outcomes in patients receiving on-demand sedation:a randomized controlled trial[J].Gastrointest Endosc,2017,85(1):210-218.
[20]Patel AM,Green J,Jowhari F,et al.Use of warm carbon dioxide insufflators does not affect intra-colonic gas temperature and has no effect on polyp detection rate during colonoscopy-a randomized controlled trial[J].Endosc Int Open,2017,5(7):E683-E689.
[2]赖华生,林志昭,孟琰,等.结直肠癌早期筛查技术研究进展[J].现代消化及介入诊疗,2017,22(5):752-756.
[3]Ekkelenkamp VE,Dowler K,Valori RM,et al.Patient comfort and quality in colonoscopy[J].World J Gastroenterol,2013,19(15):2355-2361.
[4]Cadoni S,Sanna S,Gallittu P,et al.A randomized,controlled trial comparing real-time insertion pain during colonoscopy confirmed water exchange to be superior to water immersion in enhancing patient comfort[J].Gastrointest Endosc,2015,81(3):557-566.
[5]Lynch I,Hayes A,Buffum MD,et al.Insufflation using carbon dioxide versus room air during colonoscopy:comparison of patient comfort,recovery time,and nursing resources[J].Gastroenterol Nurs,2015,38(3):211-217.
[6]Mc Commons R,Wheeler M,Houston S.Colonoscopy Comfort:An Evidence-Based Practice Project[J].Gastroenterol Nurs,2016,39(3):212-215.
[7]蒋玉立.社区大肠癌高危人群肠镜检查依从性的意愿及影响因素分析[J].中国初级卫生保健,2017,31(8):10-12.
[8]杨成,项立,赵新华,等.结肠镜退镜时间的研究现状及思考[J].中华消化内镜杂志,2016,33(8):512-513.
[9]Leung FW,Jia H.Expert endorsement,a prerequisite to general acceptance,marked a significant milestone in the history of water exchange colonoscopy[J].Gastrointest Endosc,2018,88(4):598-600.
[10]Ojidu H,Palmer H,Lewandowski J,et al.Patient tolerance and acceptance of different colonic imaging modalities:an observational cohort study[J].Eur J Gastroenterol Hepatol,2018,30(5):520-525.
[11]张荣,田叶红,张利云,等.注水法在结肠镜检查中的应用价值[J].山西医科大学学报,2016,47(1):71-74.
[12]陈桂权,詹磊磊,刘宇虎,等.注水式结肠镜在肠镜检查中的应用体会[J].中国内镜杂志,2015,21(12):1252-1256.
[13]王薇,薄禄龙,邓小明.二氧化碳充气在妇科术后无痛结肠镜检中的安全性研究[J].国际麻醉学与复苏杂志,2016,37(9):786-789.
[14]张海燕,谭婧宇,梁玲,等.重庆地区结直肠癌高危人群结直肠镜免费筛查的依从性及影响因素研究[J].重庆医科大学学报,2016,41(12):1263-1267.
[15]陈佩松,马镇坚,张洪实,等.老年患者结肠镜检查肠道准备不良的影响因素分析[J].现代消化及介入诊疗,2017,22(3):358-360.
[16]Feisthammel J,Vu TK,Hollenbach M,et al.Is CO2 insufflation an amelioration of routine colonoscopy?[J].Minerva Gastroenterol Dietol,2018,64(3):193-200.
[17]俞海洋,万元春,王金婷,等.安装透明帽并二氧化碳气体注入对结肠镜检查进镜速度及结肠息肉检出率的影响[J].中国内镜杂志,2017,23(8):81-85.
[18]杜志强,徐文革,张静,等.水交换结肠镜结合二氧化碳注气行结肠镜检查的临床分析[J].中华结直肠疾病电子杂志,2016,5(2):163-166.
[19]Cadoni S,Falt P,Gallittu P,et al.Impact of carbon dioxide insufflation and water exchange on postcolonoscopy outcomes in patients receiving on-demand sedation:a randomized controlled trial[J].Gastrointest Endosc,2017,85(1):210-218.
[20]Patel AM,Green J,Jowhari F,et al.Use of warm carbon dioxide insufflators does not affect intra-colonic gas temperature and has no effect on polyp detection rate during colonoscopy-a randomized controlled trial[J].Endosc Int Open,2017,5(7):E683-E689.