超细内镜、无痛内镜与普通内镜临床对比研究

目的评价超细胃镜、无痛胃镜与普通胃镜应用于上消化道疾病诊疗的安全性、效果和价值。方法随机对有上消化道疾病的274例患者做经超细胃镜、普通胃镜或无痛胃镜检查，其中经口超细胃镜82组例，经鼻超细胃镜组32例，普通胃镜组80例，无痛胃镜组80例。对胃镜检查前、检查中患者的血压、心率、血氧饱和度及检查过程中的反应进行观察。结果普通胃镜患者检查中收缩压、舒张压、心率较检查前有显著性升高（P〈0．05）。无痛胃镜患者检查中收缩压、心率及血氧饱和度较检查前有显著性降低（P〈0．05），舒张压有所下降，但与检查前比较，差异无统计学意义（P〉0．05）。而经口与经鼻胃镜患者检查中收缩压、舒张压、心率较检查前有升高，但差异无统计学意义（P〉0．05）。经鼻超细胃镜检查中流涎、恶心、呕吐、躁动、咳嗽等不适症状明显减少，而无痛胃镜检查中无流涎、恶心呕吐、躁动、咳嗽等不适症状，检查后患者均对受检过程无记忆，愿意再次接受内镜检查。结论四种胃镜检查中，经鼻超细胃镜的安全性优于无痛胃镜，而无痛胃镜的耐受性最好，可应用于精神障碍病人和对内镜有恐惧感的病人。

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

Objective： To investigate the safety, efficacy and significance of transnasal ultrathin gastroscopy, anesthetic gastroscopy and ordinary gastroscopy in the diagnosis and therapeutic treatment in patients with upper gastrointestinal （ UGI ） tract disorders.
Methods： The 274 cases were divided into 4 groups randomly. 82 cases underwent trans altrathin gastroscopy by mouth, 32 cases underwent transnasal ultrathin gastroscopy, 80 underwent anesthetic gastroscopy and 80 underwent ordinary gastroscopy respectively. The changes of blood pressure （ BP ） , heart rates （ HR ） , blood oxygen saturation （ SPO^2 ） and the discomforts of the patients were recorded both before and during the insertion of the gastroscope respectively.
Results： Thcrc wcrc no significant changcs in HR, SBP, DBP and SPO2 in patients before and during transnasal gastroscopy （P〉0.05） . The level of HR, SBP and SPO^2 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） . The discomforts of patients were much less during transnasal gastroscopy than those during ordinary gastroscopy, and there was no obvious discomforts during anesthetic gastroscopy.
Conclusion： The transnasal gastroscopy is more safe than anesthetic gastroscopy, and the anesthetic gastroscopy is more acceptable than both transnasal gastroscopy and normal gastroscopy.