无痛胃镜在上消化道出血治疗中的应用

目的探讨无痛胃镜在上消化道出血治疗中的应用价值。方法回顾性分析笔者所在医院2009年9月～2012年3月住院行胃镜治疗的上消化道出血患者205例临床资料,根据不同的诊治方法分为两组,无痛胃镜组115例选择采用丙泊芬镇静麻醉技术的无痛胃镜诊治术,90例选择行普通胃镜诊治术设为普通胃镜组,观察两组操作中心率、血压、呼吸、血氧饱和度、心电图波形变化。结果两组患者术前心率、收缩压、舒张压、呼吸、血氧饱和度比较,差异无统计学意义(P>0.05);普通胃镜组在胃镜诊治过程中心率、收缩压、舒张压、呼吸要明显高于无痛胃镜组,而血氧饱和度则明显低于无痛胃镜组,差异有统计学意义(P<0.05)。并发症总发生率,普通胃镜组为22.22%(20/90)、无痛胃镜组为5.22%(6/115),差异有统计学意义(P<0.05)。结论无痛胃镜下行上消化道止血术具有止血效果好、安全性高、患者舒适等优点,值得推广应用。

Application of painless gastroscope in the treatment of upper gastrointestinal bleeding

Objective To explore the application value of painless gastroscope in the treatment of upper gastrointestinal bleeding. Methods 205 cases’ clinical datum with upper gastrointestinal bleeding and had been treated by gastroscope from September 2009 to March 2012 were selected and analyzed retrospectively, according to the different treatments,they were divided into two groups, 115 cases in painless gastroscope group were treated by painless gastroscope with propofol sedation, 90 cases in normal gastroscopy group were treated by normal gastroscopy.To observe the changes of heart rate,blood pressure,respiration,blood oxygen saturation and ECG wave of the two groups. Results Preoperatively,the heart rate,systolic blood pressure,diastolic blood pressure,respiration and blood oxygen saturation of the two groups had no significant difference(P > 0.05). In the treatment of gastroscope,the heart rate,systolic blood pressure,diastolic blood pressure and respiration of normal gastroscope were significantly higher than those in painless gastroscope group,the blood oxygen saturation was significantly lower than that in the painless gastroscope group(P < 0.05). The complication overall incidence of normal gastroscopy group was 22.22%(20/90), painless gastroscope group was 5.22%(6/115), the difference between the two groups was significant(P < 0.05). Conclusion Painless gastroscope in the treatment of upper gastrointestinal bleeding can get a better hemostatic effect, make patients comfortable, be safe, it should be widely applied.