无痛内镜术在160例次食管胃静脉曲张治疗中的应用

Application of painless endoscopy in gastroesophageal varices treatment

目的探讨无痛内镜术在食管胃静脉曲张诊疗中的效果和安全性。方法回顾性分析160例次行内镜下食管胃静脉曲张硬化或组织胶注射患者的资料,比较检查前、中、后的血压、心率、血氧饱和度变化,记录操作时间、苏醒时间、药物剂量、术中出血情况及不良反应,并与同期8例普通胃镜下行食管胃静脉曲张硬化治疗的患者进行比较。结果 160例次接受无痛胃镜下食管胃静脉曲张硬化或组织胶注射的患者术中收缩压与术前相比下降16.7%(P<0.01),舒张压下降26.8%(P<0.01),术后恢复,术中心率、血氧饱和度较术前差异无统计学意义(P>0.05)。无痛组急诊止血率为93.8%,吸入性肺炎的发生率为1.9%。结论无痛胃镜下行食管胃静脉曲张硬化和组织胶注射安全、有效、耐受性好。

Objective To evaluate the efficiency and security under painless endoscopy in gastroesophageal varices treatment.Methods Retrospective analysis was made in 72 patients with gastroesophageal varices who accepted 160 times of sclerotherapy or tissue adhesive injection under painless endoscopy.The variation of blood pressure（Bp）,heart rate（HR） and oxygen saturation（SpO2）during examination were observed.The operation and sleeping time,doses of anesthesia drugs and advers reation were recorded.The data of 8 cases accepted sclerotherapy under the ordinary endoscopy were compared.Results In painless group,systolic blood pressure（SBP）and diastolic blood pressure（DBP）were respectively reduced by 16.7%（P0.01）and 26.8%（P0.01）,but these changes were temporary,could can be recovered after the treatment.There were not remarkable differences in HR and SpO2 before and in the treatment（P0.05）.The emergency hemostasis rate under the painless endoscopy was 93.8%,the incidence rate of aspiration pneumonia was 1.9%.Conclusion Sclerotherapy or tissue adhesive injection with gastroesophageal varices under painless endoscopy is an effective,comfortable and safe method.