二氧化碳充气CT结肠成像的临床研究  

A clinical study of CO2 insufflation for CT colon imaging

作　　者：刘敏 胡红杰[2] 王子荣[1] 陈建丰[3] 刘承宏[1] 戚乐[1] 周晓璇 陈青青 LIU Min;HU Hongjie;WANG Zirong;CHEN Jianfeng;LIU Chenghong;QI Le;ZHOU Xiaoxuan;CHEN Qingqing(Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, P.R.China;Department of Radiology, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hangzhou 310016, P.R.China;Department of Proctology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, P.R.China)

机构地区：[1]杭州师范大学附属医院放射科,浙江杭州310015 [2]浙江大学医学院附属邵逸夫医院放射科,浙江杭州310016 [3]杭州师范大学附属医院肛肠外科,浙江杭州310015

出　　处：《医学影像学杂志》2021年第8期1367-1371,共5页Journal of Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2021ZH029)。

摘　　要：目的以二氧化碳(CO_(2))代替室内空气(RA)作为介质进行CT结肠成像检查(CTC),探讨CTC的影像诊断效能,以及患者的舒适度。方法选取临床CTC检查患者60例,随机分成观察组和对照组,各30例。肠道准备后,观察组经肛门注入CO_(2),对照组经肛门注入RA。由2位医师对CTC图像进行分析,以4点量表法评估结肠充盈情况及检查结束1 h后气体吸收情况,以评价CO_(2)在CTC检查中的影像效能及其吸收速度。以视觉评估法评价患者舒适度。结果CO_(2)充气结肠大部分节段扩张良好,与RA组充气差异无统计学意义(P>0.05);1 h后两组气体残气量,CO_(2)组明显低于RA组,差异有统计学意义(P<0.05)。两组患者在充气后均耐受度良好,无明显不适感觉;两组患者在充气过程中舒适度差异无统计学意义;充气后15 min及充气后1 h后舒适度观察组高于对照组,差异有统计学意义(P<0.05)。结论利用CO_(2)替代RA进行CTC检查,不但可以获得相同的结肠扩张效果,影像学诊断效能满意,而且可以让患者具有较好的舒适度,同时也更适合一次肠道准备同时需要做结肠镜检查的患者。Objective To explore the diagnostic effectiveness of CT colonography(CTC)and the comfort of patients in using carbon dioxide(CO_(2))instead of indoor air(RA)as a medium.Methods A total of 60 patients with clinical CTC were collected and randomly divided into experimental group and control group,with 30 in each group.After bowel preparation,the experimental group was injected with CO_(2)through the anus,and the control group was injected with RA.The CTC images were analyzed by 2 doctors,and the colonic filling condition and gas absorption after 1 hour after the examination were evaluated on a 4-point scale,in order to evaluate the image efficiency and absorption rate of CO_(2)in CTC examination.Visual assessment was used to assess patient comfort.Results Most segments of the CO_(2)aerated colon expanded well,and there was no significant difference with the RA group(P>0.05);after 1 hour,the residual gas volume in the CO_(2)group was significantly lower than that in the RA group,with statistical differences(P<0.05).Both groups of patients were well tolerated after inflation,and there was no obvious discomfort.There was no significant difference in comfort between the two groups of patients before and after inflatio;the comfort of the CO_(2)group was higher than the control AR group after 15minutes and 1 hour of inflation,with statistical differences(P<0.001).Most segments of the colon expanded well and there was no significant difference between CO_(2)inflation and RA inflation.Conclusion Using CO_(2)instead of RA for CTC examination,we can not only obtain the same colonic dilatation effect and satisfactory imaging diagnostic efficiency,but also provide patients with better comfort,which is more suitable for patients who need to undergo colonoscopy after an intestinal preparation.

关 键 词：结肠 二氧化碳 空气 体层摄影术 X线计算机 

分 类 号：R322.4[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]