CO2 注入在可能困难的结肠镜检查中的应用：经验较少的结肠镜医师使用时的疗效。
CO(2) insufflation for potentially difficult colonoscopies: efficacy when used by less experienced colonoscopists.
机构信息
Department of Endoscopy, Okayama University Hospital, Kita-ku, Okayama 700-8558, Japan.
出版信息
World J Gastroenterol. 2009 Nov 7;15(41):5186-92. doi: 10.3748/wjg.15.5186.
AIM
To clarify the effectiveness of CO(2) insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists.
METHODS
One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO(2) or standard air insufflation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist (EC) group and a less experienced colonoscopist (LEC) group. Study measurements included a 100-mm visual analogue scale (VAS) for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times.
RESULTS
Examination times did not differ, however, VAS scores in the CO(2) group were significantly better than in the air group (P < 0.001, two-way ANOVA) from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group (P = 0.29), however, VAS scores for CO(2) insufflation were significantly better than air insufflation in the LEC group (P = 0.023) immediately after colonoscopies and up to 4 h afterwards.
CONCLUSION
CO(2) insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.
目的
明确 CO₂ 注气在潜在困难结肠镜检查病例中的有效性，尤其是与结肠镜检查医师的经验水平相关的情况。
方法
本研究纳入了 120 例潜在困难病例，包括体重指数较低的女性患者，以及有早期腹部和/或盆腔开放性手术史或既往诊断为左侧结肠憩室病的患者。接受无镇静作用的小儿可变硬度结肠镜检查的患者根据 CO₂ 或标准空气注气分为两组。根据各自结肠镜检查医师的经验水平，对两种注气程序进行了评估，将其分为经验丰富的结肠镜检查医师（EC）组和经验较少的结肠镜检查医师（LEC）组。研究测量包括患者在结肠镜检查期间和检查后 100mm 视觉模拟评分（VAS）的疼痛，以及插入盲肠和退出时间。
结果
检查时间没有差异，但 CO₂ 组的 VAS 评分明显优于空气组（P < 0.001，双因素方差分析），从手术后立即到 2 小时后。在 EC 组中，两种注气方法之间没有显著差异（P = 0.29），但在 LEC 组中，CO₂ 注气后的 VAS 评分明显优于空气注气（P = 0.023），在结肠镜检查后立即和 4 小时后。
结论
当由 LEC 进行时，CO₂ 注气可减轻潜在困难结肠镜检查病例后患者的疼痛。
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