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目的研究注入CO_2对结肠镜内镜下黏膜切除术(EMR)和内镜下黏膜剥离术(ESD)治疗者视觉模拟评分法(VAS评分)及腹痛严重程度的影响。方法选取2015年2月至2016年2月入西安交通大学第二附属医院并需要进行结肠镜下EMR和ESD的患者,共100例,然后依照患者意愿和手术需求将100例患者分为空气组和CO_2组,分别在治疗过程中充入空气和CO_2,并对两组患者的VAS评分,肛门排气情况和二氧化碳分压(PaCO_2)进行观测。结果两组患者在治疗中腹痛感基本相同,差异无统计学意义(P>0.05);但在治疗结束时,结束后1 h,6 h和24 h时,CO_2组患者的腹痛VAS评分低于空气组,差异有统计学意义(P<0.05);CO_2组患者在治疗后1 h和6 h肛门的排气情况低于空气组患者,差异有统计学意义(P<0.05);在治疗24 h后两组患者肛门排气情况基本相同,差异无统计学意义(P>0.05);两组患者的PaCO_2在治疗前,治疗中和治疗后基本相同,差异无统计学意义(P>0.05)。结论进行结肠镜EMR和ESD治疗时充入CO_2能够有效降低患者的腹部疼痛感。
Objective To investigate the effects of CO2 injection on visual analog scale (VAS) score and the severity of abdominal pain in patients undergoing endoscopic mucosal resection (EMR) and endoscopic mucosal dissection (ESD). Methods A total of 100 patients were enrolled in the Second Affiliated Hospital of Xi’an Jiaotong University from February 2015 to February 2016, and underwent EMR and ESD for colonoscopy. 100 patients were divided into air group And CO_2 group were respectively filled with air and CO_2 during the course of treatment. The VAS score, anal exhaust and PaCO_2 of both groups were observed. Results The pain scores of the two groups were basically the same in the middle of treatment, but the difference was not statistically significant (P> 0.05). However, the VAS scores of abdominal pain in the CO_2 group were lower than those in the air at the end of treatment, 1 h, 6 h and 24 h (P <0.05). The exhaust of anus in CO_2 group was lower than that in air group at 1 h and 6 h after treatment (P <0.05), and the difference was statistically significant at 24 h The anal exhaust in the latter two groups was basically the same, with no significant difference (P> 0.05). PaCO_2 in both groups was basically the same before and after treatment, with no significant difference (P> 0.05). CONCLUSION: CO 2 treatment during colonoscopy with EMR and ESD can effectively reduce abdominal pain in patients.