一次性鞘套胃镜系统在边远地区巡诊中的应用

Evaluation of disposable-sheathed gastroscope system in visit round of remote areas

目的评估一次性鞘套胃镜系统在边远地区巡诊中的使用性能。方法1120例患者按随机数字表法随机分为两组，观察组568例接受一次性鞘套胃镜检查，对照组552例接受常规胃镜检查。记录内镜操作时间、洗消时间、总周转时间、检查结果、患者对检查时感受的评价以及内镜操作和洗消过程中发生的不良事件，并行组间对比分析。结果观察组平均操作时间（4．9±1．4）min，比对照组的（4．1±1．3）min延长了近1min（t=5．689，P=0．000）；但平均洗消时间（4．9±0．2）min，比对照组的（35．0±0．2）min缩短了近30min（t=-1271．145，P=0．000）；总周转时间（9．9±1．3）min，仅为对照组（39．0±1．4）min的1／4左右（t=-185．223，P=0．000）；病变总检出率为38．9％（221／568），与对照组的43．3％（239／552）相似（χ^2=2．228，P=0．136）。两组患者检查时的感受无明显差异（P=0．075）。观察组一次性鞘套在穿脱及内镜操作过程中均未发生破裂情况，亦未发生重大不良好事件。结论一次性鞘套胃镜系统具有便捷、快速、安全的特性，在边远地区巡诊中具有较好的应用价值。

Objective To investigate the practical efficiency of a novel disposable-sheathed gastro- scope system in visit round of remote areas. Methods A total of 1120 participants were randomized to accept gastroscopy with either a disposable-sheathed gastroscope system （ n = 568 ） or a standard system （ n = 552）. The duration of the endoscopic procedure and cleaning and disinfection was recorded. The results of gastroscopy, the feedback of the procedure from patients and any adverse events presented during the proce- dure were also recorded. Results The mean procedure time was significantly longer with the sheathed system （4. 9 ± 1.4 min） than with the standard one （ 4. 1 ± 1.3 min, t = 5. 689, P = 0. 000）. However, the duration of cleaning and disinfection were significantly shorter with the sheathed gastroscope （4. 9 ± 0. 2 min） than with the standard one （35.0 ±0. 2 min, t = - 1271. 145, P =0. 000）. So the total instrument turn-over time for sheathed system was only a quarter of the time for standard endoscope （9. 9 ± 1.3 vs. 39.0 ± 1.4 min）. The detection rate of abnormalities and patients＇feedback were similar between with two systems. No sheath leakage or rupture was observed. Conclusion The sheathed gastroscope system is safe, convenient and rapid in manipulation, and is valuable in clinical practice, especially in visit rounds of remote areas.