中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2014年
4期
243-246
,共4页
何小建%张志坚%李达周%刘建强%李海涛
何小建%張誌堅%李達週%劉建彊%李海濤
하소건%장지견%리체주%류건강%리해도
胆胰管造影术,内窥镜逆行%二氧化碳%腹痛%腹胀
膽胰管造影術,內窺鏡逆行%二氧化碳%腹痛%腹脹
담이관조영술,내규경역행%이양화탄%복통%복창
Cholangiopancreatography,endoscopic retrograde%Carbon dioxide%Abdominal pain%Abdominal distension
目的 探讨在ERCP术中CO2作为注入气体的安全性及有效性.方法 选取2012年1月至12月南京军区福州总医院消化内科在全麻下行ERCP的患者140例.采用随机双盲对照法,按照患者检查顺序,依据事先选定好的随机数字分成CO2注入组(CO2组)和空气注入组(空气组),分别为65例和75例.采用视觉模拟评分(VAS)评价两组术后1、3、6、24h腹痛和腹胀程度,监测术前、术中、检查结束时、术后24 h的心率、血压、血氧饱和度、动脉血二氧化碳分压.对比检查前后腹部平片显示的肠管胀气情况,记录术前及术后1h的腰围、操作时间、苏醒时间、术中与术后并发症.结果 CO2组术后3 h腹痛VAS为(4.08±1.36)分,显著低于空气组的(4.59±1.66)分(P＜0.01);术后1、3、6h腹胀VAS分别为(1.78±1.90)、(0.72±1.15)、(0.12±0.45)分,显著低于空气组的(3.53±2.71)、(2.51±2.04)、(0.84±1.24)分(P值均＜0.05);术中血氧饱和度为(93.29±1.40)％,显著低于空气组的(93.52±1.06)％(P＜0.01);术后1h腰围增加(2.48±1.33) cm,显著低于空气组的(3.56±2.13)cm(P=0.00);平均苏醒时间为(11.2±2.5)min,显著长于空气组的(9.7±1.7) min(P =0.00).腹部平片提示空气组的肠管胀气较CO2组严重(P=0.04).结论 ERCP中注入CO2是安全、有效的,在减轻患者检查后的腹痛、腹胀等方面优于空气注入法.
目的 探討在ERCP術中CO2作為註入氣體的安全性及有效性.方法 選取2012年1月至12月南京軍區福州總醫院消化內科在全痳下行ERCP的患者140例.採用隨機雙盲對照法,按照患者檢查順序,依據事先選定好的隨機數字分成CO2註入組(CO2組)和空氣註入組(空氣組),分彆為65例和75例.採用視覺模擬評分(VAS)評價兩組術後1、3、6、24h腹痛和腹脹程度,鑑測術前、術中、檢查結束時、術後24 h的心率、血壓、血氧飽和度、動脈血二氧化碳分壓.對比檢查前後腹部平片顯示的腸管脹氣情況,記錄術前及術後1h的腰圍、操作時間、囌醒時間、術中與術後併髮癥.結果 CO2組術後3 h腹痛VAS為(4.08±1.36)分,顯著低于空氣組的(4.59±1.66)分(P＜0.01);術後1、3、6h腹脹VAS分彆為(1.78±1.90)、(0.72±1.15)、(0.12±0.45)分,顯著低于空氣組的(3.53±2.71)、(2.51±2.04)、(0.84±1.24)分(P值均＜0.05);術中血氧飽和度為(93.29±1.40)％,顯著低于空氣組的(93.52±1.06)％(P＜0.01);術後1h腰圍增加(2.48±1.33) cm,顯著低于空氣組的(3.56±2.13)cm(P=0.00);平均囌醒時間為(11.2±2.5)min,顯著長于空氣組的(9.7±1.7) min(P =0.00).腹部平片提示空氣組的腸管脹氣較CO2組嚴重(P=0.04).結論 ERCP中註入CO2是安全、有效的,在減輕患者檢查後的腹痛、腹脹等方麵優于空氣註入法.
목적 탐토재ERCP술중CO2작위주입기체적안전성급유효성.방법 선취2012년1월지12월남경군구복주총의원소화내과재전마하행ERCP적환자140례.채용수궤쌍맹대조법,안조환자검사순서,의거사선선정호적수궤수자분성CO2주입조(CO2조)화공기주입조(공기조),분별위65례화75례.채용시각모의평분(VAS)평개량조술후1、3、6、24h복통화복창정도,감측술전、술중、검사결속시、술후24 h적심솔、혈압、혈양포화도、동맥혈이양화탄분압.대비검사전후복부평편현시적장관창기정황,기록술전급술후1h적요위、조작시간、소성시간、술중여술후병발증.결과 CO2조술후3 h복통VAS위(4.08±1.36)분,현저저우공기조적(4.59±1.66)분(P＜0.01);술후1、3、6h복창VAS분별위(1.78±1.90)、(0.72±1.15)、(0.12±0.45)분,현저저우공기조적(3.53±2.71)、(2.51±2.04)、(0.84±1.24)분(P치균＜0.05);술중혈양포화도위(93.29±1.40)％,현저저우공기조적(93.52±1.06)％(P＜0.01);술후1h요위증가(2.48±1.33) cm,현저저우공기조적(3.56±2.13)cm(P=0.00);평균소성시간위(11.2±2.5)min,현저장우공기조적(9.7±1.7) min(P =0.00).복부평편제시공기조적장관창기교CO2조엄중(P=0.04).결론 ERCP중주입CO2시안전、유효적,재감경환자검사후적복통、복창등방면우우공기주입법.
Objective To investigate the safety,efficacy of CO2 insufflations during ERCP.Methods One hundred and forty eligible patients who underwent ERCP in Fuzhou General Hospital of Nanjing Military Command from January to December 2012 were randomized according to random digits in a double blind manner to receive either CO2 insufflations or air insufflations (65 vs 75).The patient's experience of abdominal pain and distension at 1 h,2 h,6 h and 24 h post-ERCP were evaluated by visual analogue scale (VAS).The heart rates,blood pressure,SpO2,PaCO2 were recorded before,during,after ERCP,and 24 h after the examination.Plain abdominal radiographic images were collected to show abdominal distention before and after ERCP,waist circumference,operative time,recovery time,intraoperative and post-ERCP complications were also determined.Results Post-ERCP the VAS of abdominal pain at 3 h was (4.08 ± 1.36) in CO2 group,which was significantly lower than that in air group [(4.59 ± 1.66),P ＜ 0.01].The VAS of abdominal distension at 1 h,3 h,6 h after ERCP were(1.78 ± 1.90),(0.72 ± 1.15),(0.12 ±0.45),which were significantly lower than those in air group [(3.53 ± 2.71),(2.51 ± 2.04),(0.84 ± 1.24),P ＜ 0.05] ; the intraoperative SpO2 was (93.29 ± 1.40)％,which was significantly lower than that in air group [(93.52 ± 1.06) ％,P ＜ 0.01].The waist circumference at 1 h after ERCP increased by (2.48 ± 1.33)cm,which was significantly lower than that in air group [(3.56 ± 2.13) cm,P =0.00).Recovery time was (11.2 ± 2.5) rain in CO2 group,which was significantly longer than that in air group [(9.7 ± 1.7) min,P =0.00].And the difference between the two groups was statistically significant.The plain abdominal radiographic images showed the degree of bowel distension was severer in air group than that in CO2 group (P =0.04).Conclusions CO2 insufflations are safe and efficacy during ERCP.CO2 can better alleviate abdominal pain and distension than air.
