老年人无痛结肠镜检查的可行性研究  

The feasibility of painless colonoscopy in elderly patients

作　　者：魏智民[1] 高峰 杨雪[3] 胡亦新[1] 范利[3] 白杨[4] 智发朝[4] 

机构地区：[1]解放军军医进修学院,100853 [2]总参警卫局卫生保健处,100017 [3]解放军总医院南楼临床部,100853 [4]南方医科大学南方医院消化内科,510515

出　　处：《现代消化及介入诊疗》2010年第1期20-23,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：背景欧美及日本等国有关老年人消化内镜的指南均不推荐无痛结肠镜检查用于65岁以上的老年人,此年龄界限是否适合我国尚无资料可鉴。目的研究无痛结肠镜在65～70岁老年人中应用的可行性。方法对128例接受无痛结肠镜诊治(无痛组)和同期119例接受常规结肠镜检查(对照组)的65～70岁老年患者的血压、心率、血氧饱和度(SpO2),疼痛程度,检查成功率,不良反应,苏醒时间以及满意度和复检意向进行比较分析。结果无痛组操作过程中均可见一过性血压和心率下降,与检查前比较有显著性差异,但检查结束后可恢复术前水平。对照组检查过程中均有不同程度的血压升高和心率加快,检查前、后比较有显著性差异。两组操作过程前、中、后的SpO2无显著性差异。无痛组和对照组的安静率、成功率、满意率、复检意向率分别是94.5%,25.2%;99.2%,92.4%;98.4%,61.3%;98.4%,31.9%;无痛组均明显优于对照组。结论无痛结肠镜在基本生命体征指标、患者反应,检查成功率、并发症发生率以及患者满意度和复检意向率方面均明显优于或等同于常规结肠镜检查,可见适合无痛结肠镜检查的老年人年龄上限可从65岁提高至70岁。Background In Europe and America, the indication of colonoscopy for elderly patients sug- gests the painless colonoscopy is only suitable to elderly people （less than 65-year old）. It is not clear if the guidlines fit the Chinese. Objective To study the feasibility of painless colonoscopy application in elderly people of 65- 70 year old. Methods One hundred and twenty-eight patients aged 65 - 70 year old underwent painless colonoscopic diagnosis and treatment （painless group）, and 119 control patients received conventional colonoscopy （control group）. Blood pressure, heart rate, oxygen saturation （SpO2）, the degree of pain, inspection success rate, adverse reactions, and consciousness time （from stopping drug delivery to the time that patient could response）, as well as satisfaction and intention to conduct a comparative analysis of re-examination were compared. Results Blood pressure and heart rate were significantly declined during examination in painless group, but restored to original levels after examination. The blood pressure and heart rate were significantly increased in control group during the checking process. There was no significant difference for SpO2 between 2 groups before, during and after operation. 94.5% of patients in pain-free group could keep quiet during whole procedure, while only 25.2% in control group. Check success rate was 99.2% （125/126） inp ainless group, while 92.4% （110/119） in control group.Satisfaction rate and review intention was 98.4% in painless group, while only 61.3% in control group. Conclusion Painless colonoscopy can be savely used for 70 year old patients without anesthesia contraindication.

关 键 词：老年人 无痛结肠镜 

分 类 号：R574.62[医药卫生—消化系统]