二氧化碳充气在妇科术后无痛结肠镜检中的安全性研究

目的 比较妇科手术后行结肠镜检查中注入空气与二氧化碳(carbon dioxide,CO2)的效果. 方法 选取我院妇科手术后行常规无痛结肠镜检查患者62例,采用随机数字表法分为C02组和空气组(每组31例),结肠镜检查中分别注入C02、空气.记录两组患者结肠镜检查成功率、操作时间、丙泊酚用量、恢复时间及检查后不同时间的腹痛程度,比较检查前后HR、MAP、Sp02、经皮二氧化碳分压(transcutaneous carbon dioxide partial pressure,PtcC02)的变化,VAS评估检查后15 min、1h、3h、6h及24 h腹痛程度. 结果 两组患者检查成功率、操作时间、丙泊酚用量和恢复时间差异无统计学意义(P＞0.05);两组患者检查前、检查中及检查后HR、MAP、Sp02、PtcCO2差异无统计学意义(P＞0.05);C02组患者检查后15 min、1h、3h、6h、24 h时点VAS评分均显著低于空气组(21.6±9.5)分比(46.7±14.1)分、(14.4±5.4)分比(32.6±9.6)分、(9.1±3.6)分比(22.9±8.4)分、(4.3±1.1)分比(9.7±3.5)分、(2.3±1.1)分比(4.1±1.9)分](P＜0.05). 结论 妇科术后患者行无痛结肠镜检查时注入CO2代替空气安全有效,且能减轻检查后腹痛程度.

A comparative study of injecting air or carbon dioxide in patients undergoing routine painless colonoscopy after gynecological surgery

Objective To investigate and compare the effects of injecting air or carbon dioxide (CO2) in patients undergoing routine colonoscopy after gynecological surgery.Methods Sixty-two patients undergoing painless colonoscopy after gynecological surgery were divided into CO2 group and air group by random number table method with 31 patients in each group,CO2 and air were injected to patients,respectively.The success rate of colonoscopy,procedure time,dose of propofol,recovery time and the degree of abdominal pain at different time after colonoscopy were recorded.The changes of HR,MAP,SpO2 and transcutaneous carbon dioxide partial pressure(PtcCO2) before and after the procedure were measured and compared at the same time point.Each patient rated,using VAS,the intensity of abdominal pain at 15 min,1 h,3 h,6 h and 24 h after colonoscopy.Results There was no difference in the success rate of examination,procedure time,dose of propofol and recovery time between the two groups (P＞0.05).Furthermore,there was no difference in HR,MAP,SpO2 and PtcCO2 between the two groups before,during and after the examination,respectively (P＞0.05).However,at 15 min,1 h,3 h,6 h,24 h after examination,the VAS scores of patients in the CO2 group were significantly lower than that of the air group with the data of (21.6±9.5) vs (46.7±14.1),(14.4±5.4) vs (32.6±9.6),(9.1±3.6) vs (22.9±8.4),(4.3±1.1) vs (9.7±3.5),(2.3±1.1) vs (4.1 ±1.9)](P＜0.05),respectively.Conclusions CO2 is safe and effective in patients undergoing routine painless colonoscopy after gynecological surgery,moreover,it can reduce the degree of abdominal pain after the examination.