张晓庆

[摘要] 目的 探討老年患者结肠镜检查中注气法和注水法对患者疼痛及应激水平的影响。 方法 回顾性选取2018年6月至2020年6月于本院接受结肠镜检查的老年患者60例，依据检查方法分为注水法组、注气法组两组，每组各30例。统计分析两组患者的检查时间、进镜深度、疼痛程度、辅助操作使用情况、血清炎性因子、应激反应指标水平。 结果 注水法组患者的进镜时间、退镜时间、插管总时间（13.8±2.1）min、（7.7±1.0）min、（21.5±4.1）min均显著长于注气法组（11.0±3.6）min、（6.3±1.5）min、（18.7±3.5）min，差异有统计学意义（P<0.05），VAS评分（4.0±0.9）分显著低于注气法组（5.4±1.3）分，差异有统计学意义（P<0.05）。注水法组患者的体位变换使用率56.7%（17/30）显著高于注气法组46.7%（14/30），差异有统计学意义（P<0.05）。注水法组患者检查后较检查前的血清TNF-α、CRP、IL-8水平升高幅度均显著低于注气法组，差异有统计学意义（P<0.05）。注水法组患者检查后较检查前的血清AngⅡ、AD、NA水平升高幅度均显著低于注气法组，差异有统计学意义（P<0.05）。结论 老年患者结肠镜检查中注水法较注气法更能有效减轻患者疼痛及应激水平。

[关键词] 结肠镜检查;注气法;注水法;疼痛;应激水平

[中图分类号] R574.62          [文献标识码] B          [文章编号] 1673-9701（2021）33-0105-04

[Abstract] Objective To investigate the effects of gas injection and saline injection on pain and stress levels in elderly patients with colonoscopy. Methods Sixty elderly patients who received colonoscopy in our hospital from June 2018 to June 2020 were retrospectively selected. According to the inspection method， they were divided into two groups： water injection group and gas injection group， with 30 patients in each group. The examination time， depth of the colonoscope， degree of pain， use of auxiliary procedures， levels of serum inflammatory factors and stress response indexes in 2 groups were statistically analyzed. Results The colonoscope insertion time， colonoscope withdrawal time and total intubation time in the saline injection group were （13.8±2.1） minutes， （7.7±1.0） minutes and （21.5±4.1） minutes， which were significantly longer than those in the gas injection group as （11.0±3.6） minutes， （6.3±1.5） minutes and （6.3±1.5） minutes， and the differences were statistically significant（P<0.05）. The VAS scores of the saline injection group（4.0±0.9） were significantly lower than those of the gas injection group， with statistically significant differences （P<0.05）. The utilization rate of body position change in the saline injection group was 56.7% （17/30）， which was significantly higher than 46.7% （14/30） in the gas injection group， and the difference was statistically significant （P<0.05）. The increases of serum TNF-α， CRP and IL-8 levels in the saline injection group after examination were significantly lower than those in the gas injection group， and the differences were statistically significant（P<0.05）. The increases of serum Ang Ⅱ， AD and NA after examination compared with those before examination of the patients in the saline injection group were lower than those in the gas injection group， and the differences were statistically significant（P<0.05）. Conclusion In elderly patients with colonoscopy， the saline injection is more effective than the gas injection in reducing pain and stress levels.

[Key words] Colonoscopy; Gas injection; Saline injection; Pain; Stress level

在大肠疾病的诊断中，结肠镜检查是临床最常采用的方法[1]。近年来，注水结肠镜在临床得到了日益广泛的应用，其在检查过程中将空气用温水取代掉，将视野获取过来，一方面能够促进检查过程中患者腹痛程度的减轻，另一方面还能够促进肠镜到达回肠末端成功率的提升、检查速度的加快。本研究统计分析了2018年6月至2020年6月本院接受结肠镜检查的老年患者60例的临床资料，探讨了老年患者结肠镜检查中注气法和注水法对患者疼痛及应激水平的影响。现报道如下。

1 资料与方法

1.1 一般资料

回顾性选取2018年6月至2020年6月本院接受结肠镜检查的老年患者60例，纳入标准：①有不明原因腹痛、便秘、排便习惯改变等临床症状者;②具有完整的临床资料者;③有结肠镜检查指征者。排除标准：①有严重心肺疾患者;②有盆腹腔手术史者;③应用过镇静镇痛类药物者[2]。……