Comparison of the application effect of Warm-water or Carbon Dioxide Insufflation in difficult colonoscopy
- VernacularTitle:温水或二氧化碳气体在困难结肠镜检查中的应用效果比较
- Author:
Sihui HOU
1
;
Yan WANG
;
Xiaohong WANG
;
Jianqiu MENG
;
Manman ZHANG
Author Information
- Keywords: warm-water; carbon dioxide(CO2); difficult colonoscopy; randomized controlled study
- From: China Journal of Endoscopy 2024;30(11):47-52
- CountryChina
- Language:Chinese
- Abstract: Objective To compare the safety and clinical value of warm-water infusion or carbon dioxide(CO2)insufflation in difficult colonoscopy.Methods A collection of 150 patients from May 2021 to October 2023 who underwent unsedated and difficult colonoscopy were randomly divided into warm-water insufflation group(W group,n=50),CO2 insufflation group(C group,n=50)and air insufflation group(A group,n=50).Record the cecal insertion time,the abdominal pain score during the examination and 20 min and 1 h after the examination,the success rate of intubation,the polyps detection rate,the willingness to re-examine and the need for assistance in the three groups.Some patients were randomly selected to record partial pressure of end-tidal carbon dioxide(PetCO2)of pre-examination,the ileocecal and 20 min after the examination to understand CO2 retention in the body.Results The cecal insertion time of group A was longer than that of group W and group C,and group W was shorter than group C.The abdominal pain score of group A was higher than that of group W and group C at each time point,and the abdominal pain score during the examination was lower in the group W compared with group C.The success rate of intubation and the willingness to re-examination in the group A were lower than those in group W and group C,The above differences were statistically significant(P<0.05).However,there was no statistical difference between the the group W and group C in terms of success rate of intubation,willingness to re-examine,and abdominal pain score at 20 minutes and 1 hour after the examination(P>0.05).In the group W,significantly fewer patients required abdominal compression compared with the other two groups,and the rate of position conversion was significantly lower than that in group A(P<0.05).There was no significant difference in the detection rate of polyps among the three groups(P>0.05).In addition,PetCO2 of group C was within the normal range at all time points,and there was no statistical difference compared with the group A(P>0.05).Conclusion Compared with the air group,water or CO2 insufflation colonoscopy is safe and has a high success rate in difficult colonoscopy.It can reduce the patient's abdominal discomfort,especially water insufflation colonoscopy is more suitable for promotion in primary hospitals.
