Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
United European Gastroenterol J. 2016 Feb;4(1):11-7. doi: 10.1177/2050640615588024. Epub 2015 Jun 9.
The efficacy of CO2 insufflation during balloon-assisted enteroscopy remains controversial. This study aimed to perform a systematic review with meta-analysis of randomized controlled trials (RCTs) in which CO2 insufflation was compared with air insufflation in balloon-assisted enteroscopy.
PubMed, the Cochrane library, and the Igaku-Chuo-Zasshi database were searched to identify RCTs eligible for inclusion in the systematic review. Data from the eligible studies were combined to calculate the pooled odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs).
Four RCTs (461 patients) were identified. Compared with air insufflation, CO2 insufflation significantly increased intubation depth of oral enteroscopy (WMD: 55.2, 95% CI: 10.77-99.65, p = 0.015). However, there was significant heterogeneity. The intubation depth of anal enteroscopy showed no significant difference between the CO2 group and the air group. CO2 insufflation significantly reduced abdominal pain compared with air insufflation (WMD: -2.463, 95% CI: -4.452 to -0.474, p = 0.015), without significant heterogeneity. The PaCO2 or end-tidal CO2 level showed no significant difference between the CO2 group and air group.
Compared with air insufflation, CO2 insufflation during balloon-assisted enteroscopy caused less post-procedural pain without CO2 retention.
CO2 注气在气囊辅助式小肠镜检查中的疗效仍存在争议。本研究旨在对 CO2 注气与空气注气在气囊辅助式小肠镜检查中进行比较的随机对照试验（RCT）进行系统评价和荟萃分析。
检索 PubMed、Cochrane 图书馆和 Igaku-Chuo-Zasshi 数据库，以确定符合系统评价纳入标准的 RCT。对纳入研究的数据进行合并，计算汇总优势比（OR）或加权均数差（WMD）及其 95%置信区间（CI）。
共纳入 4 项 RCT（461 例患者）。与空气注气相比，CO2 注气显著增加了经口小肠镜的进镜深度（WMD：55.2，95%CI：10.77-99.65，p=0.015）。但存在显著异质性。CO2 组与空气组之间，经肛小肠镜的进镜深度无显著差异。CO2 注气显著减轻了与空气注气相比的腹痛（WMD：-2.463，95%CI：-4.452 至 -0.474，p=0.015），无显著异质性。CO2 组和空气组之间的 PaCO2 或呼气末 CO2 水平无显著差异。
与空气注气相比，CO2 注气在气囊辅助式小肠镜检查中引起的术后疼痛更少，且不会导致 CO2 潴留。
