老年人经鼻胃镜与无痛胃镜检查临床对比研究

Clinical study of transnasal gastroscopy and anodynia gastroscopy for the elderly patients

目的观察老年人经鼻胃镜检查时生命体征及术中反应,并与经口无痛胃镜相比较,探讨老年人经鼻胃镜检查的安全性与耐受性。方法选取北京老年医院接受胃镜检查的≥60岁老年患者100例,分为试验组(经鼻胃镜组)50例,对照组(无痛胃镜组)50例,比较两组患者胃镜检查时心率(HR)、收缩压(SBP)、舒张压(DBP)、血氧饱和度(SaO2)变化、术中反应及操作时间(与麻醉后行胃镜检查时间比较)。结果试验组患者胃镜检查中SBP、DBP、HR均较检查前升高,差异无统计学意义(P>0.05),SaO2较前下降,差异无统计学意义(P>0.05),检查后SBP、DBP、HR、SaO2均恢复至正常水平;胃镜检查过程中,试验组SBP、DBP、HR、SaO2分别为(129.4±6.3)、(71.3±4.2)mm Hg、(82.0±4.2)次/min、(98.0±2.9)%,均较对照组高(P<0.01),胃镜检查中对照组患者SBP、DBP、HR、SaO2分别为(110.1±3.1)、(60.2±2.3)mm Hg、(67.5±3.8)次/min、(95.3±2.0)%,均较前显著降低(均P<0.01);胃镜检查中,试验组出现恶心、呕吐等不良反应高于对照组(P<0.01),两组均无明显呛咳、躁动,术后询问患者舒适度比较,差异无统计学意义(P>0.05)。试验组胃镜操作时间较对照组稍短,差异无统计学意义(P>0.05)。结论老年人患者经鼻胃镜检查是更安全的,可耐受的。

Objective To study the safty and tolerant of Transnasal gastroscopy for the elderly patients by monitoring the changes of their vital signs during process of operating and compare with anodynia gastroscopy.Methods A total of 100 patients over 60 years old accepting gastroscopy were divided into test group（transnasal gastroscopy） and control group（anodynia gastroscopy）,with 50 cases in each group.During the process of gastroscopy,the heart rate（HR）,sys tolic blood pressure（SBP）,diastolic blood pressure（DBP）,saturation of blood oxygen（SaO2）,untoward effect operating time of elderly patients were monitored and compared between the two groups.Results HR,SBP,DBP increased during transnasal gastroscopy（P ＆gt; 0.05）,and SaO2 decreased（P ＆gt; 0.05）,and all of these indexes returned to normal after transnasal gastroscopy,the SBP,DBP,HR and SaO2 were（129.4±6.3） mm Hg,（71.3 ±4.2） mm Hg,（82.0 ±4.2） times/ min and（98.0 ±2.9）% respectively during transnasal gastroscopy,and were significantly increased in transnasal gas troscopy than anodynia gastroscopy group during process of gastroscopy（P ＆lt; 0.01）.The SBP,DBP,HR and SaO2 were（110.1±3.1） mm Hg,（60.2±2.3） mm Hg,（67.5±3.8） times/min and（95.3±2.0）% respectively and decreased during anodynia gastroscopy（P ＆lt; 0.01）,adverse reaction significantly increased in ransnasal gastroscopy group than in anodynia gastroscopy group（P ＆lt; 0.01）,there was no significant more comfortable during transnasal gastroscopy than these pa tients during anodynia gastroscopy（P ＆gt; 0.05）,there were no significant difference in operating time between two groups（P ＆gt; 0.05）.Conclusion Transnasal gastroscopy is safe and comfortable in elderly patients.