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1.
目的比较链酶蛋白酶联合二甲基硅油及糜蛋白酶联合二甲基硅油对胃镜检查清晰度影响效果。 方法选择2018年1月在山东省千佛山医院内镜中心接受胃镜检查的78例患者,按照随机、双盲原则平均分为2组,A组(链酶蛋白酶组):2万U链酶蛋白酶+1 g碳酸氢钠+二甲基硅油5 g+ 50 ml温水;B组(糜蛋白酶组):4 000 U糜蛋白酶+1 g碳酸氢钠+二甲基硅油5 g+50 ml温水。对比分析2组术中胃镜视野清晰度。 结果A组的胃窦、胃体、胃底黏膜清晰度及总内镜黏膜清晰度评分均明显优于B组(胃窦:1.7±1.0比1.2±0.5;胃体:2.6±0.8比2.1±0.8;胃底:1.9±0.8比1.5±0.7;总黏膜清晰度:6.2±2.1比4.7±1.6),差异均有统计学意义(P均<0.05)。 结论链酶蛋白酶联合二甲基硅油能够明显提高胃镜检查清晰度,且效果明显优于糜蛋白酶联合二甲基硅油。  相似文献   

2.
目的 探讨集束化护理策略在无痛胃肠镜联合检查患者安全管理中的实践及意义。方法 选取2017 年 12月—2018 年12月在上海某三甲医院消化内镜中心实行无痛胃肠镜联合检查的692例患者进行随机分组,对照组328 例行常规护理,观察组364例行集束化护理策略,对禁食、禁水执行标准率、肠道准备质量以及术中不良事件发生率进行对比分析。结果 观察组禁食、禁水执行标准率及术中不良事件发生率均显著低于对照组(P < 0.05)。观察组肠道准备情况优于对照组(P < 0.05)。结论 对无痛胃肠镜联合检查患者实行集束化护理策略有助于确保患者安全、提高肠道准备质量、降低不良事件发生率,改善医疗护理服务质量。  相似文献   

3.
目的观察生长抑素联合前列地尔治疗重症急性胰腺炎的疗效及对部分血清炎症因子的影响。 方法选取云南省第三人民医院在2015年5月至2017年5月收治的73例重症急性胰腺炎患者,按照随机数字表法分为观察组和对照组,对照组在常规治疗基础上加用生长抑素治疗,观察组在常规治疗基础上加用生长抑素联合前列地尔治疗,2周为一疗程;观察两组患者临床疗效、症状缓解时间、血清炎症因子水平、不良反应及死亡率。 结果观察组临床总有效率为87.5%(28/32),对照组临床总有效率为75.6%(31/41),比较差异具有统计学意义(P<0.05);观察组腹痛缓解时间、肠功能恢复时间、血清淀粉酶(AMY)恢复时间、平均住院时间均低于对照组[(3.2±1.2)d vs.(4.9±1.1)d、(3.7±1.1)d vs.(5.4±1.4)d、(5.8±1.1)d vs.(7.5±1.3)d、(14.8±5.2)d vs.(18.6±4.6)d],差异均具有统计学意义(P<0.05);治疗后两组患者急性生理与慢性健康评分Ⅱ(APACHEⅡ评分)、白细胞(WBC)、超敏C反应蛋白(CRP)、AMY、丙氨酸转氨酶(ALT)、血清肌酐(Cr)水平明显下降,治疗后7 d、14 d观察组APACHEⅡ评分、WBC、CRP、AMY、ALT、Cr水平明显低于对照组[(9.2±2.2)分vs.(10.5±1.5)分、(12.2±3.2)×109/L vs.(13.9±2.9)×109/L、(72.3±17.3)mg/L vs.(106.5±20.1)mg/L、(389.6±57.6)U/L vs.(1066.3±152.4)U/L、(62.9±8.8)U/L vs.(80.4±11.5)U/L、(82.5±18.6)μmol/L vs.(108.6±20.5)μmol/L;(6.8±2.0)分vs.(8.3±2.4)分、(7.5±1.2)×109/L vs.(8.6±1.4)×109/L、(24.2±8.6)mg/L vs.(52.7±15.2)mg/L、(72.6±15.2)U/L vs.(138.2±25.6)U/L、(22.5±6.4)U/L vs.(42.6±12.8)U/L、(46.2±10.4)μmol/L vs.(70.1±16.2)μmol/L],差异均具有统计学意义(P<0.05);治疗后两组患者血清内毒素、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平明显下降,观察组血清内毒素、TNF-α、IL-6水平明显低于对照组[(45.3±9.8)Eu/ml vs.(53.2±10.3)Eu/ml、(62.5±13.7)ng/L vs.(76.3±14.2)ng/L、(60.3±11.4)ng/L vs.(81.2±20.9)ng/L],差异均有统计学意义(P均<0.05);观察组死亡率为12.5%(4/32),对照组死亡率为24.4%(10/41),两组比较差异有统计学意义(P<0.05)。 结论生长抑素联合前列地尔治疗重症急性胰腺炎疗效显著,可有效降低患者血清炎症因子水平,值得临床推广。  相似文献   

4.
目的探讨丙泊酚联合地佐辛在中老年患者无痛胃肠镜中的麻醉效果。方法选取2011年5月至2013年8月在我院进行无痛胃肠镜检查40~72岁的104例患者为研究对象,将其随机分为观察组(丙泊酚联合地佐辛组)和对照组(丙泊酚联合芬太尼组),每组各52例,将两组患者的唤醒时间、定向力恢复时间、不良反应发生率、术后VRS及术后2min的Ramsay评分,术前、术中5 min、术后5 min的血流动力学指标水平进行统计及比较。结果观察组唤醒时间、术后VRS评分、术前、术中5分钟血流动力学指标及麻醉效果均优于对照组(P均0.05)。结论丙泊酚联合地佐辛在中老年患者无痛胃肠镜检查治中效果良好,不良反应更小,值得推广应用。  相似文献   

5.
目的 探讨联合无痛胃肠镜检查患者肠道准备的优化方案,为提高肠道准备的质量及肠镜下结肠病变的检出率提供新的策略.方法 以2016年9月至2017年5月就诊于西安交通大学第二附属医院行联合无痛胃肠镜检查的120名健康人群为研究对象,以随机分组的方式分为观察组与对照组,两组人群均常规服用泻剂,观察组加用全消化道动力药(莫沙必...  相似文献   

6.
目的 探讨医护麻三位一体化护理模式应用在老年患者无痛肠镜肠道准备中的效果。方法 采用便利抽样法选取门诊老年患者172例为研究对象,按照就诊时间进行分组,试验组采取医护麻三位一体化模式护理,对照组采取常规护理。对比两组患者渥太华肠道准备评分量表(OBPS)、肠道准备充分率、肠镜检查耗时、Kolcaba舒适状况评分、麻醉不良反应发生率。结果 试验组OBPS评分低于对照组;肠道准备充分率74.74%(71/95)高于对照组50.65%(39/77),P<0.05;试验组肠镜检查进镜时间(7.13±1.89)分钟低于对照组(8.35±1.95)分钟,P<0.05;试验组Kolcaba舒适状况评分中生理、心理、精神、社会文化及总分均高于对照组,P<0.05;恶心、呕吐、腹胀、腹痛及头晕两组的发生率差异没有统计学意义,P>0.05。结论 医护麻三位一体化护理模式对老年患者行无痛肠镜肠道准备具有理想的干预效果,能够明显提高患者肠道准备充分率,提升依从性,且无不良反应,值得临床参考借鉴。  相似文献   

7.
刘壮 《内科》2013,8(3):276-277
目的探讨无痛胃肠镜联合检查在临床中的应用效果与安全性,为临床应用提供参考。方法选择2009年2月至2012年2月在我院治疗并均需要进行胃镜、肠镜检查的患者998例。按照自愿的原则将患者随机分为观察组500例和对照组498例,观察组实施一次性麻醉胃肠镜联合检查,对照组在不同时段内分别进行无痛胃镜、肠镜检查。观察对比两组患者的术中反应、检查所需时间、术后反应以及麻醉药物的用量的差异。结果观察组术中、术后并发症发生率均低于对照组;检查所需时间较对照组短;麻醉药物用量少于对照组,差异有统计学意义(P〈0.05)。结论无痛胃、肠镜联合检查对于需要进行胃镜和肠镜检查的患者来说,是一个较好方法。  相似文献   

8.
目的评价地佐辛联合异丙酚对无痛胃肠镜术的麻醉效果及安全性。方法收集接受无痛胃肠镜检查的患者共232例(胃肠镜136例,肠镜96例),随机分为观察组与对照组,后者单用异丙酚麻醉,观察组在异丙酚的基础上加用地佐辛。比较两组患者的生命体征、苏醒时间、异丙酚用量以及术后恶心感评分(VAS)等方面的差异。结果与对照组比较,术中观察组患者血压及心率显著低于对照组,而血氧饱和度高于对照组(P〈0.05);观察组的异丙酚用量为(83.39±7.92)mg,显著少于对照组的(121.83±17.74)mg(t=-6.992,P=0.000);观察组患者VAS评分明显低于对照组(f=1.782,P=0.036),但两组间的苏醒时间无统计学差异(P〉0.05)。结论地佐辛联合异丙酚应用于无痛胃肠镜的麻醉效果及血液动力学安全性优于单用异丙酚。  相似文献   

9.
[目的]分析无痛胃肠镜诊疗术的临床应用效果及安全性。[方法]选取需作胃肠镜检查的患者100例,随机分为观察组和对照组,每组各50例。观察组采用无痛胃肠镜诊疗术,在进行胃肠镜检查和治疗前,给予患者麻醉镇痛;对照组患者直接进行胃肠镜检查和治疗。观察2组患者整个手术过程中的心率(HR)、血氧饱和度(SpO2)、血压(BP)等生命指征,并比较2组患者术后的疗效。[结果]观察组患者在胃肠镜诊治疗前后HR、SpO2及BP变化较为平稳,组内比较差异无统计学意义(P0.05);对照组患者在胃肠镜诊治前后HR、BP变化波动幅度较大,但SpO2的变化较平稳,组内比较差异显著(P0.05)。观察组患者治疗后总有效率为98%,明显高于对照组76%;观察组患者胃肠镜诊治前非常紧张人数所占比例12%,明显低于对照组,观察组患者心理状态优于对照组;观察组患者在胃肠镜诊疗过程中出现的咽喉反射、不良反应的发生率均明显低于对照组,且患者对胃肠镜操作的满意度为94%,明显高于对照组(60%),P0.05。[结论]无痛胃肠镜诊疗术与常规胃肠镜相比,具有适应性好、减轻患者疼痛、不良反应少等优点,检查过程中对患者HR、SpO2、BP等无明显影响,安全性高,且患者对操作的满意度高,值得在临床上广泛应用。但其价格昂贵,在临床上普及还具有一定局限性。  相似文献   

10.
目的探究阿法替尼和顺铂分别联合培美曲塞治疗晚期EFGR突变型非小细胞肺癌晚期(non-small-cell carcinoma, NSCLC)的临床疗效差异,明确阿法替尼临床疗效。 方法选取我院2016年3月至2017年9月收治的107例EFGR突变阳性晚期NSCLC患者的病例资料,接受顺铂+培美曲治疗的NSCLC患者51例为对照组,接受塞阿法替尼+培美曲塞治疗的NSCLC患者56例,为研究组,观察两组患者疗效、无进展生存时间(progression-free survival time, PFS)以及生存时间(overall survival, OS)等。 结果研究组患者ORR及DCR比例均明显高于对照组[53.57% vs. 31.37%,85.71% vs. 66.67%,P<0.05];研究组患者PFS及OS均明显高于对照组[7.2月vs. 6.0月,11.75月vs. 9.5月,P<0.05];治疗后,研究组患者神经元特异性烯醇化酶(neuron-specific enolase, NSE)、癌胚抗原(carcinoembryonic antigen, CEA)、细胞角蛋白19片段(cytokeratin 19 fragment, CYFRA21-1)均低于对照组[(11.79±8.51)ng/ml vs.(15.26±8.22)ng/ml,(14.54±8.77)ng/ml vs.(18.37±9.35)ng/ml,(3.45±2.68)ng/ml vs.(5.41±3.54)ng/ml,P<0.05];Ⅰ~Ⅱ级不良反应中,研究组恶心呕吐、肾功能损害及脱发人数比例均明显低于对照组[12.50% vs. 33.33%,5.36% vs. 27.45%,16.07% vs. 35.29%,P<0.05],研究组皮疹/痤疮人数比例明显高于对照组[25.00% vs. 7.84%,P<0.05];治疗后,躯体方面、心理方面、社会方面及总体感觉评分均高于对照组[(77.41±5.25)分vs.(72.12±5.08)分,(74.37±5.40)分vs.(67.52±5.32)分,(79.25±5.98)分vs.(74.32±5.71)分,(71.21±5.45)分vs.(66.61±5.20)分,P<0.05]。 结论阿法替尼联合培美曲塞一线治疗EGFR突变型晚期NSCLC患者的疗效更为显著,明显提高无进展生存时间及生存时间,明显提高生活质量,同时具有较高安全性,值得临床推广应用。  相似文献   

11.
目的 探讨右美托咪定联合瑞芬太尼监护麻醉技术在急诊内镜下治疗肝硬化胃底静脉曲张破裂出血的效果。方法 选取2019年4月至2019年10月在首都医科大学附属北京地坛医院急诊行胃镜下胃底静脉曲张破裂出血治疗的肝硬化患者60例为研究对象,采用随机数字表法分为试验组和对照组,每组30例,试验组给予右美托咪定+瑞芬太尼麻醉,对照组给予等量生理盐水,比较两组患者给药前(T0)、胃镜置入时(T1)、胃镜置入后5 min(T2)、胃镜退出时(T3)、胃镜后4 h(T4)心率(heart rate,HR)、呼吸率(respiration rate,RR)、平均动脉压(mean arterial pressure,MAP)、血氧饱和度(oxygen saturation,SpO2)和脑电双频指数(bispectral index,BIS)。比较两组患者不良反应发生率、患者满意度及医生满意度。结果 试验组T2和T3时间点HR [T2:(77.2±14.6)次/min vs(95.7±6.8)次/min;T3:(77.2±12.5)次/min vs(87.1±7.0)次/min]和RR [T2:(13.7±2...  相似文献   

12.
We aimed to investigate the safety and efficacy of endoscopic resection for the treatment of gastric gastrointestinal stromal tumors (GISTs) under single-channel gastroscopy and double-channel gastroscopy.We identified 154 patients with GISTs of the stomach who underwent endoscopic resection and were retrospectively analyzed at our hospital between May 2016 and March 2020, including 49 patients by single-channel gastroscopy and 105 patients by double-channel gastroscopy. We observed the clinical efficacy, complications, and safety of endoscopic resection of gastric GISTs, and the data were evaluated retrospectively.All patients underwent endoscopic resection successfully, without conversion to open surgery. In the single-channel gastroscopy group, 7 patients had lesions in the gastric cardia, 17 in the gastric fundus, 20 in the gastric corpus, and 5 in the gastric antrum. In the double-channel gastroscopy group, 13 patients had lesions in the gastric cardia, 34 in the gastric fundus, 46 in the gastric body, 10 in the gastric antrum, 1 in the pylorus, and 1 in the gastric angular incisure. The double-channel gastroscopy group had a shorter operation time than the single-channel gastroscopy group (59.9 ± 34.9 minutes vs 74.8 ± 26.7 minutes; P = .009 and P < .01, respectively), while they also had a lower perforation rate than the single-channel gastroscopy group (34.3% vs 51.0%; P = .048 and P < .05, respectively). No residual or recurrent lesions were discovered in any patients by gastroscopy reexamination.Both single-channel gastroscopy and double-channel gastroscopy can provide safe, effective, feasible endoscopic resection. However, double-channel gastroscopy has some distinct advantages in endoscopic resection.  相似文献   

13.
SUMMARY. Anastomotic leakage after esophagectomy and esophagogastrostomy depends on the vascularization of the gastric conduit. So far, no adequate methods are available to monitor postoperatively mucosal microcirculation of the gastric conduit. The aim of this experimental study was to assess a recently developed microprobe with a microlight‐guide spectrophotometer (O2C, Fa. LEA Medizintechnik, Gießen, Germany) to quantitatively measure gastric mucosal blood flow (MBF) and mucosal oxygen saturation (MOS) of different gastric areas. Eighteen patients without gastric pathology were included in this study. During conventional gastroscopy the microprobe was introduced via the working channel of a standard endoscope and positioned in well‐defined areas of the antrum and fundus. The tip of the microprobe consisted of a combined laser Doppler and tissue spectrometer measuring continuously the MBF (perfusion units, PU) and MOS (SO2, in %). The mean MOS of the antrum was significantly higher compared with the fundus (antrum: 82% ± 7.9 standard deviation [SD], fundus: 72% ± 10.4; P = 0.0002). The mean MBF was not significantly different between antrum and fundus (antrum: 201 PU ± 40 SD, fundus: 223 PU ± 29 SD). This study demonstrates the feasibility of the gastric O2C microprobe to measure parameters of gastric microcirculation from the endoluminal side.  相似文献   

14.
无痛消化内镜诊疗术的临床应用(附5 200例报告)   总被引:2,自引:0,他引:2  
目的探讨咪唑安定、异丙酚等药物在消化内镜检查及治疗中应用的安全性和依从性。方法分析5 200例接受消化内镜检查及治疗的患者予咪唑安定 异丙酚 氯胺酮等静脉复合麻醉的临床情况,并以同期5 000例常规操作者为对照组。比较2组患者舒适程度、接受内镜复查及检查成功率。结果(1)无痛组患者感觉舒适率65%,无痛苦率100%,愿意复查率97%。对照组分别为0%、5.5%、14%。(P<0.001)。无痛组肠镜至回盲部率100%,高于对照组的98%。(2)无痛组有8例血氧饱和度下降经处理后顺利完成。本组病例无重大并发症发生。结论咪唑安定、异丙酚、氯胺酮等药物在消化内镜检查及治疗中应用患者感觉舒适、无痛苦,安全性高,增加了患者的依从性。值得临床推广。  相似文献   

15.
目的探讨异丙酚联合小剂量麻黄碱在无痛胃镜诊疗中的有效性及防止循环呼吸抑制方面的安全性。方法将300例拟行无痛胃镜检查的患者随机分为对照组和观察组,每组150例,两组均用异丙酚静脉注射进行全身麻醉,异丙酚用量为1.8mg/kg,观察组静脉注射麻黄碱用量为0.18mg/kg。记录两组术前、术中及术后的收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)的变化以及并发症和医生患者满意度。结果观察组与对照组之间的临床相关指标比较,两组术中SBP、DBP、HR差异有统计学意义(P〈0.05),SpO2差异无统计学意义(P〉0.05)。结论异丙酚联合小剂量麻黄碱对无痛胃镜诊疗患者的循环、呼吸抑制小,快速诱导与清醒,在无痛胃镜中更加安全有效。  相似文献   

16.
The precise mechanisms of acute damage and the role of gastric mucosal blood flow in gastric mucosal injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs) remain uncertain. The aim of this study was to evaluate the preventive effect of rebamipide on gastric mucosal injury and reduction of gastric mucosal blood flow (GMBF) after ibuprofen administration. Twenty healthy volunteers were randomized two groups. The rebamipide group took ibuprofen, 1800 mg/day, and rebamipide, 100 mg t.i.d., for 7 days. The placebo group took ibuprofen, 1800 mg/day. The numbers of gastric ulcer subjects were three in the placebo group and zero in the rebamipide group. The mean modified Lanza score after ibuprofen administration was significantly higher in the placebo group than the rebamipide group (2.9±1.7 vs. 1.3±1.0, respectively; P=0.032). The GMBF of the placebo group was significantly decreased at antrum from baseline, from 2.8±0.5 to 2.0±0.5 tissue perfusion units (P=0.005). There was no difference in GMBF change in the rebamipide group. Gastric mucosal injury was correlated with GMBF reduction in antrum (r=−0.677, P=0.001). In conclusion, it is suggested that the decrease in GMBF may have been associated with NSAID-induced gastric mucosal injury, and rebamipide may have prevented NSIAD-induced gastric mucosal injury by maintaining GMBF in healthy subjects.  相似文献   

17.
F Marotta  H Tajiri  P Safran  E Fesce  G Ideo 《Digestion》1999,60(6):538-543
Twenty-two healthy teetotal volunteers underwent gastroscopy during which biopsy samples from the antrum and body were taken for chemiluminescence assay, routine histology, and for malonyldialdehyde, xanthine oxidase and glutathione determination. Subjects were divided into 2 groups which, in a double-blind fashion, were randomly and orally given either (a) Bionormalizer 9 g at bedtime and 3 h prior examination, or (b) flavored sugar 9 g as placebo. During the second gastroscopy 40 ml of 80% ethanol were sprayed perendoscopically. Gastroscopy with biopsy was repeated 60 min later. As compared to the placebo group, subjects given Bionormalizer showed significantly reduced gastric mucosal damage at endoscopy and the histological level. When considering the placebo group, ethanol administration brought about a significant increase in the luminol-amplified chemiluminescence response in gastric mucosa as compared to the baseline value which was correlated with the histological score. The mean chemiluminescence value in the Bionormalizer group was significantly lower than in the placebo group. Ethanol ingestion brought about a significant increase in xanthine oxidase and malonyldialdehyde together with a decreased glutathione concentration. Bionormalizer significantly prevented such changes. The present data suggest that the natural antioxidant Bionormalizer when given orally promotes an effective protection against ethanol-induced gastric mucosal damage.  相似文献   

18.
AIM: To study the influence of Helicobacter pylori (Hp) on the gastric mucosal barrier (GMB) by the measurement of the potential difference (PD). METHODS: Fifty seven chronic gastritis cases were diagnosed endoscopically and confirmed by forceps mucosal biopsy. PD was measured by the Takeuchi method, and Hp was detected by both culture (modified Skirrow method) and press printing method with the Giemsa stain. Patients were divided randomly into three groups (De-Nol, WeiTong-Ling, and Placebo) for a course of 6 wk therapy. RESULTS: PD across the mucosa of antrum was significantly lower in Hp (+) patients than in Hp (-) patients (16.44 ± 2.36 vs 19.58 ± 2.44, P < 0.0001). In Hp (+) patients, PD in the antrum increased markedly (16.88 ± 2.56 vs 20.03 ± 2.21, P < 0.0001) after Hp was cleared up by the De-Nol treatment. CONCLUSION: Our data strongly indicated that Hp infection might cause a gastric mucosal barrier to be impaired markedly while the clearance of Hp by De-Nol recovered the integrity of the gastric mucosal barrier significantly.  相似文献   

19.
BACKGROUND/AIMS: This study was designed to investigate the role of gastric acid in the extent of H. pylori-induced gastritis. METHODS: Twenty eight mice were inoculated with live H. pylori. They were allocated into four groups. Mice in group I received no treatment, group II mice were treated with sham injection, group III received 125 microg/kg body weight of pentagastrin, while group IV received 250 microg/kg body weight of pentagastrin subcutaneously three times a week. After 7 months, the mucosal pH, H. pylori density, neutrophils and monocytes infiltration, and the degree of atrophy were assessed in the stomach. RESULTS: In the gastric body, the densities of H. pylori were not different among groups. The degree of neutrophil infiltration was significantly lower in group IV compared to other groups (p<0.05). The degree of monocyte infiltration was also significantly lower in group IV than group III (p<0.05). In the gastric antrum, there was no significant difference of the H. pylori density, neutrophil and monocyte infiltration, and degree of atrophy among the groups. The mice with the gastric mucosal pH lower than mean of 3.2 had significant lower level of H. pylori density (1.4 vs. 2.4, p=0.04), and infiltration of neutrophils (0.9 vs. 2.3, p=0.018), and monocytes (1.2 vs. 1.8; p=0.011) than the those with mucosal pH above 3.2 in the body of stomach. CONCLUSIONS: Gastric acid plays a role in suppressing the proximal propagation of H. pylori-induced gastritis to the body of stomach.  相似文献   

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