无痛胃镜在食管静脉曲张治疗中的应用

目的研究在无痛胃镜下进行黏膜层加固硬化术对患者的影响。方法82例肝硬化患者,共进行167例次内镜下黏膜层加固硬化治疗,将其分成两组,其中普通胃镜组52例次,无痛胃镜组115例次。分别观察两组术前、术中、术后心率、血压、呼吸、血氧饱和度,患者术中不良反应,术中出血情况,术后调查患者对内镜下治疗的耐受情况及医师对手术的满意度,无痛胃镜组观察术前及术后7d的肝功能及凝血常规试验变化。结果无痛组胃镜术中收缩压与术前相比下降9.3%(P<0.01),舒张压下降15.1%(P<0.01),但为一过性,术后可恢复;普通胃镜组术中收缩压升高10.5%(P<0.01),舒张压升高13.4%(P<0.01),亦为一过性,术后可恢复;两组心率、呼吸、血氧饱和度无显著性差异(P>0.05);术中操作医师对食管蠕动及视野满意度无痛胃镜组明显高于普通胃镜组(P<0.01)。结论无痛胃镜下行食管静脉曲张套扎术后黏膜层加固硬化术是一种安全、易被患者接受的治疗方法。

Painless gastroscopy in the treatment of esophageal varices

Objective To study the effects of mucosal strengthening and hardening under painless gastroscopy in the treatment of esophageal varices of liver cirrhosis patients liver cirrhosis.Methods The 82 patients were given 167 times of mucosal strengthening and hardening under endoscepic treatment. These cases were randomly divided into two groups: control group(n=52) and painless group(n=115);their HR, Bp, R and SpO2 before, after and during the treatment were respectively recorded, adverse reaction and bleeding in the process of endoscopic treatment were observed, satisfaction rate of the physicians and endurance rate of the patients were questioned,liver function and routine clotting test before and 7 days after the treatment were compared.Results In painless group, systolic blood pressure(SBP) and diastolic blood pressure(DBP) was respectively reduced by 9.3% (P<0.01) and 15.1%(P<0.01), but these changes were temporary, which can be recovered after the treatment. In control group, temporary changes can also be observed, SBP and DBP was respectively increased by 10.5%(P<0.01) and13.4%(P<0.01.) There were not remarkable differences in HR, R, Bp and SpO2 between the two group(P>0.05).Compared with control group, adverse reactions were obviously reduced in painless group and there was not remarkable difference in the function of liver before or after this painless treatment between both groups(P>0.05).Conclusion By using of propofol combined with midazaolam, mucosal strengthening and hardening under endoscopic treatment can achieve effective, painless, comfortable and safe outcomes.