超细胃镜、无痛胃镜与普通胃镜62例临床对比研究

目的探讨超细胃镜、无痛胃镜、普通胃镜对上消化道疾病诊断及治疗的耐受性及安全性价值。方法将我科2010年5月至2011年5月收治的186例上消化道疾病患者随机分为三组各62例,分别给予超细胃镜、无痛胃镜、普通胃镜检查,观察胃镜检查过程患者的不适反应及心率、血压、血氧饱和度的变化。结果经统计对比,三组在正确诊断率方面无统计学差异;检查前超细胃镜组、无痛胃镜组、普通胃镜组检查前出现紧张不安等不适反应分别占41%、32%、95%;三者检查中出现恶心、呕吐等不适反应分别为19.3%、4.8%、79.0%;与普通胃镜相比,超细胃镜与无痛胃镜检查不适反应少,患者耐受性高,差异具有统计学意义(P<0.05)。超细胃镜检查中患者的心率、舒张压、收缩压与检查前比较都有升高,血氧饱和度检查中略低于检查前,但均无统计学意义(P>0.05);无痛胃镜组各指标均较检查前显著性降低,差异有统计学意义(P<0.05);普通胃镜组检查中患者的心率、舒张压、收缩压较检查前显著性增高,差异有统计学意义;血氧饱和度无明显变化,统计学上无差异(P>0.05)。结论三种胃镜检查均安全可靠,超细胃镜的观察指标波动范围最小,与其他二者比较,安全性最好;无痛胃镜痛苦最小,受检者耐受性最高,优于超细胃镜及普通胃镜;诊断正确率三者无差异。

A Comparative Clinical Study of 62 cases on The Transnasal Ultrathin Gastroscopy, Anesthetic Gastroscopy and Ordinary Gastroscopy

To investigate the safety, tolerance of transnasal ultrathin gastroscopy, anesthetic gastroscopy and ordinary gastroscopy in the diagnosis and therapeutic treatment in patients with upper gastrointestinal（UGI）tract disorders. Methods 186 UGI cases from 2010.5 to 2011.5 were analyzed. The cases were divided into 3 groups randomly. Each 62 cases underwent transnasal ultrathin gastroscopy, anesthetic gastroscopy and ordinary gastroscopy respectively. The changes of heart rates（HR）, blood pressure（BP）, blood oxygen saturation（SpO2） and the discomforts of the patients were recorded both before and during the insertion of the gastroscope respectively. Results There were no statistically significant of diagnostic accuracy rate. The propotion of discomforts before insertion of transnasal ultrathin gastroscopy, anesthetic gastroscopy and ordinary gastroscopy respectively is 41%, 32%, 95%; during the insertion, the propotion respectively is 19.3%, 4.8%, 79.0%; compared with ordinary gastroscopy, the differences have statistically significant. The level of HR, SBP and DBP rised, while SpO2 dropped during transnasal gastroscopy, but there wcrc no statistically significant before and during transnasal gastroscopy（P〉 0.05）. The level of HR, SBP and SpO2 dropped significantly in those during anesthetic gastroscopy（P〈 0.05）, while the level of HR, SBP, DBP rised markedly during ordinary gastroscopy （P〈 0.05）,and SpO2 was not statistically significant（P 〉 0.05）. Conclusion All three gastroscopys were safe.The fluctuation rage of outcome measure which transnasal gastroscopy is minimum ,the safety is the best among in three methods;anesthetic gastroscopy is more acceptable than both transnasal gastroscopv and ordinary zastroscoov. There was no difference of diagnostic accuracy rate.