结肠镜检查过程中疼痛危险因素分析.PDFVIP

·482 · doi 10.3969/j.issn. 1673-4254.2017.04.10 J South Med Univ, 2017, 37(4): 482-487 临床研究 结肠镜检查过程中疼痛的结肠镜检查过程中疼痛的危险因素分析危险因素分析 赖雪莹，汤小伟，黄思霖，龚 伟，智发朝，刘思德，陈 烨 南方医科大学南方医院消化内科，广东 广州 510515 摘要：目的分析结肠镜检查过程中患者疼痛的危险因素，建立肠镜疼痛的预测模型，为肠镜检查前是否使用镇静麻醉药物提供 理论参考。方法 回顾性收集2016 年6~9 月在南方医科大学南方医院消化内镜中心283 例结肠镜检查患者临床资料，并收集患 者对肠镜的疼痛视觉模拟评分，进行单因素分析及Logistic 回归分析，建立疼痛预测模型。结果 患者疼痛视觉模拟评分≥5 分 时肠镜检查完成率明显降低（P0.000）；单因素分析发现女性、有盆腹腔手术史、无肠镜检查史、术前有腹痛主诉、肠镜操作者经 验少、自主估计疼痛程度高、低BMI 指数与患者肠镜检查疼痛有关（P0.05）；Logistic 回归显示，BMI、肠镜操作者经验和自主估 Y Y 计疼痛程度3 个变量进入预测模型（P0.05）：P=e /（1+e ），Y=0.049-0.124×X -0.97×X + 1.713×A +0.781×A +0.147×A ，敏感性 1 2 1 2 3 70.3% ，特异性67.5%。结论 自主估计疼痛程度高、肠镜操作者经验少以及低BMI 指数是患者进行肠镜检查出现疼痛的独立危 险因素，肠镜检查前评估肠镜疼痛危险因素可更好指导肠镜检查前镇静麻醉药物的使用。 关键词：结肠镜；疼痛；危险因素；麻醉肠镜 Risk factors of pain during colonoscopic examination LAI Xueying, TANG Xiaowei, HUANG Silin, GONG Wei, ZHI Fachao, LIU Side, CHEN Ye Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China Abstract: Objective To investigate the risk factorsthat predict pain during colonoscopy for decision of sedation or analgesia before the examination. Methods A total of 283 consecutive patients undergoing colonoscopicexamination at Nanfang Hospital between July, 2016 and September, 2016were retrospectively analyzed. The clinical data and visual analogue scale after the examination were analyzed to identify the risk factors for pain during colonoscopy using univariate analysis and multivariate logistic regression. A risk stratification model for predicting pain in colonoscopy was established. Results The completion rate of the procedure was significantly