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首页> 美国卫生研究院文献>Endoscopy International Open >Efficacy and safety of carbon dioxide insufflation versus air insufflation during endoscopic retrograde cholangiopancreatography in randomized controlled trials: a systematic review and meta-analysis
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Efficacy and safety of carbon dioxide insufflation versus air insufflation during endoscopic retrograde cholangiopancreatography in randomized controlled trials: a systematic review and meta-analysis

机译：内镜逆行胰胆管造影术中二氧化碳吹入与空气吹入的有效性和安全性在随机对照试验中：系统评价和荟萃分析

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>Background and study aims  Ambient air is the most commonly used gas for insufflation in endoscopic procedures worldwide. However, prolonged absorption of air during endoscopic examinations may cause pain and abdominal distension. Carbon dioxide insufflation (CO 2 i) has been increasingly used as an alternative to ambient air insufflation (AAi) in many endoscopic procedures due to its fast diffusion properties and less abdominal distention and pain. For endoscopic retrograde cholangiopancreatography (ERCP), use of CO 2 for insufflation is adequate because this procedure is complex and prolonged. Some randomized controlled trials (RCTs) have evaluated the efficacy and safety of CO 2 as an insufflation method during ERCP but presented conflicting results. This systematic review and meta-analysis with only RCTs evaluated the efficacy and safety of CO 2 i versus AAi during ERCP. >Methods  A literature search was performed using online databases with no restriction regarding idiom or year of publication. Data were extracted by two authors according to a predefined data extraction form. Outcomes evaluated were abdominal pain and distension, complications, procedure duration, and CO 2 levels. >Results Eight studies (919 patients) were included. Significant results favoring CO2i were less abdominal distension after 1 h (MD: −1.41 [−1.81; −1.0], 95 % CI, I² = 15 %,P < 0.00001) and less abdominal pain after 1 h (MD: −23.80 [−27.50; −20.10], 95 %CI, I² = 9 %,P < 0.00001) and after 6 h (MD: −7.00 [−8.66; −5.33]; 95 % CI, I² = 0 %,P < 0.00001).>Conclusion Use of CO2i instead of AAi during ERCP is safe and associated with less abdominal distension and pain after the procedure.
机译：>背景和研究目的环境空气是全世界内窥镜检查过程中最常用于吹入气体的气体。但是，在内窥镜检查期间长时间吸收空气可能会引起疼痛和腹胀。二氧化碳吹入法（CO 2 i）由于其快速扩散的特性以及较少的腹部扩张和疼痛感，已在许多内窥镜手术中越来越多地用作替代环境空气吹入法（AAi）的手段。对于内窥镜逆行胰胆管造影术（ERCP），使用CO 2进行吹气就足够了，因为此过程很复杂且时间较长。一些随机对照试验（RCT）评估了ERCP期间CO 2作为吹气方法的有效性和安全性，但得出了相互矛盾的结果。这项仅使用RCT进行的系统评价和荟萃分析评估了ERCP期间CO 2 i与Aai的疗效和安全性。 >方法使用在线数据库进行文献搜索，没有关于成语或出版年份的限制。两位作者根据预定义的数据提取表提取了数据。评估的结果为腹痛和腹胀，并发症，手术时间和CO 2水平。>结果包括八项研究（919名患者）。有利于CO的重大成果21小时后我的腹胀较少（MD：-1.41 [-1.81； -1.0]，95％CI，I²= 15％，P<0.00001），在1 h后腹部疼痛减轻（MD：−23.80 [−27.50; −20.10]，95％CI，I²= 9％，P<0.00001）和之后6 h（MD：−7.00 [−8.66; −5.33]; 95％CI，I²= 0％，P<0.00001）。>结论一氧化碳的使用2ERCP期间i代替Ai是安全的，并且手术后腹部扩张和疼痛减轻。

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