Park Se Woo, Jeon Won Joong, Kim Jin Dong, Lee Sang Jin, Choi A Ra, Lee Ban Seok
*Department of Internal Medicine, Institute of Gastroenterology, Hallym University College of Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do †Department of Internal Medicine, Digestive Disease Center, Cheju Halla General Hospital, Jeju, Korea.
J Clin Gastroenterol. 2016 Jan;50(1):59-65. doi: 10.1097/MCG.0000000000000329.
The purpose of this study was to determine whether total colonic decompression after colonoscopy decreased postcolonoscopy abdominal pain.
Abdominal pain that occurs after a colonoscopy may cause significant discomfort in some patients, and residual bowel gas is thought to be a key contributor to this abdominal pain.
Asymptomatic 300 patients who underwent colonoscopy under sedation were randomized to either the decompression group or the control group. Initial colonoscopic procedure was performed uniformly in both the groups. After the colonoscopy examination was completed, the colonoscope was reinserted into the cecum, and the intraluminal air was aspirated during withdrawal in the decompression group. Abdominal pain was assessed before discharge and 24 to 48 hours after colonoscopy using a 10-point visual analogue scale (VAS).
The 2 groups were similar with regard to clinical, demographic, and procedural factors. Among 288 patients, the incidence of abdominal pain (VAS≥1) after colonoscopy was 38 (26.6%) of 143 patients in the decompression group and 95 (65.5%) of 145 patients in the control group (VAS 0.68±1.35 vs. 2.14±2.15, P<0.001). There was an 86.1% reduction rate of abdominal pain by colonic decompression, based on multivariate analysis (odds ratio 0.139 [95% confidence interval, 0.077-0.250], P<0.001). Furthermore, independent factors for abdominal pain included female gender and total duration of procedure >800 seconds. There were no reinsertion-related complications in the decompression group.
Total colonic decompression after colonoscopy has a beneficial effect and can reduce postcolonoscopy abdominal pain without additional complications.
本研究旨在确定结肠镜检查后全结肠减压是否能减轻结肠镜检查后腹痛。
结肠镜检查后出现的腹痛可能会给一些患者带来严重不适，残留肠气被认为是导致这种腹痛的关键因素。
300例接受镇静下结肠镜检查的无症状患者被随机分为减压组和对照组。两组均统一进行初始结肠镜检查。结肠镜检查完成后，将结肠镜重新插入盲肠，减压组在退出时抽吸肠腔内气体。使用10分视觉模拟量表（VAS）在出院前以及结肠镜检查后24至48小时评估腹痛情况。
两组在临床、人口统计学和操作因素方面相似。在288例患者中，结肠镜检查后腹痛（VAS≥1）的发生率在减压组143例患者中为38例（26.6%），在对照组145例患者中为95例（65.5%）（VAS 0.68±1.35 vs. 2.14±2.15，P<0.001）。基于多因素分析，结肠减压使腹痛减轻率达86.1%（优势比0.139[95%置信区间，0.077 - 0.250]，P<0.001）。此外，腹痛的独立因素包括女性性别和操作总时长>800秒。减压组未出现与重新插入相关的并发症。
结肠镜检查后全结肠减压具有有益作用，可减轻结肠镜检查后腹痛且无额外并发症。
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