无痛肠镜检查后并发缺血性肠病的分析（附36例报告）

Analysis of ischemic bowel disease after painless colonoscopy (36 cases)

摘要:

目的 探讨因无痛肠镜检查引起的缺血性肠病的临床发病特点、治疗方案及预后。方法 回顾性分析2018年1月－2020年12月该院7 422例接受肠镜检查或肠息肉内镜下治疗的患者的临床资料，根据检查方式不同分为无痛肠镜组（n = 4 615）和普通肠镜组（n = 2 807）。分析两种检查方式引起的缺血性肠病的临床特征。结果 两组患者均以腹痛、便血和发热为主要临床表现，早期给予内科治疗，均治愈。共41例患者确诊为缺血性肠病。其中，无痛肠镜组36例，普通肠镜组5例。不同检查类别患者发生缺血性肠病比较，差异有统计学意义（χ² = 11.51，P = 0.001）；内镜下摘除肠息肉与未摘除肠息肉患者发生缺血性肠病比较，差异有统计学意义（χ² = 30.75，P = 0.000）；无痛肠镜和内镜下摘除肠息肉是发生缺血性肠病的独立危险因素（OR＾ = 2.907，P = 0.032；OR＾ = 3.313，P = 0.000）。结论 无痛肠镜检查和肠息肉摘除更易诱发缺血性肠病，早期给予干预，预后良好。

Abstract:

Objective To investigate the clinical characteristics, treatment plan and prognosis of ischemic bowel disease caused by painless colonoscopy.Methods Clinical data of 7 422 patients who underwent colonoscopy or endoscopic treatment of intestinal polyps from January 2018 to December 2020 were retrospectively analyzed, they were divided into painless colonoscopy group (n = 4 615) and ordinary colonoscopy group (n = 2 807) according to the different examination method. To analyze the clinical characteristics of ischemic bowel disease caused by two examination methods.Results Two groups of patients with abdominal pain, hematochezia, fever as the main clinical manifestations, early medical treatment, all cured. A total of 41 patients were diagnosed with ischemic bowel disease, including 36 cases in the painless colonoscopy group and 5 cases in the ordinary colonoscopy group. There was statistically significant difference in ischemic bowel disease between the painless colonoscopy group and the ordinary colonoscopy group (χ² = 11.51, P = 0.001). There was statistically significant difference in the incidence of ischemic bowel disease between patients with and without endoscopic polyp removal (χ² = 30.75, P = 0.000). Painless colonoscopy and endoscopic polyp removal were independent risk factors for ischemic bowel disease (OR＾ = 2.907, P = 0.032; OR＾ = 3.313, P = 0.000).Conclusion Painless colonoscopy and intestinal polypectomy are more likely to induce the occurrence of ischemic bowel disease. Intervention as soon as possible after the occurrence of ischemic bowel disease, the prognosis is good.