无痛胃镜在老年食管静脉曲张治疗中的疗效观察

Study on the Curative Effect of Painless Gastroscopy in the Treatment for Elderly Esophageal Varices

目的观察无痛胃镜在老年食管静脉曲张治疗中的疗效。方法选取2011年8月至2012年8月成都市公共卫生临床医疗中心急诊科收治的行食管静脉曲张套扎的老年食管静脉曲张患者136例,采用随机数字表法分为无痛胃镜组88例和常规胃镜组48例,观察两组患者术前、术中和术后的心率、血压、呼吸、血氧饱和度指标变化、不良反应、出血情况、耐受程度及术前、术后7 d的肝功能情况。结果无痛胃镜组术前心率快于术中[(77.4±16.3)次/min vs(75.6±16.7)次/min],术前收缩压、舒张压高于术中[(192.1±16.6)mm Hg vs(105.6±16.2)mm Hg;(75.8±8.8)mm Hg vs(63.7±9.3)mm Hg](P<0.05);常规胃镜组术前心率慢于术中[(80.0±16.0)次/min vs(82.1±15.7)次/min],术前收缩压、舒张压低于术中[(117.4±20.4)mm Hg vs(131.0±16.7)mm Hg;(67.0±12.5)mm Hg vs(73.0±9.0)mm Hg](P<0.05);无痛胃镜组满意度55.68%,显著高于常规胃镜组的18.75%(P<0.05)。结论无痛胃镜在老年食管静脉曲张治疗中具有治疗效果好、安全性高、镜下视野清、不良反应少、患者痛苦小等优势,值得临床进一步推广和研究。

Objective To observe curative effect of painless gastroscopy in the treatment for elderly esophageal varices. Methods A total of 136 cases of elderly patients with esophageal varices treated with endoscopic varieeal ligation in Chengdu Public Health Clinical Center from Aug. 2011 to Aug. 2012 August were randomly divided into painless gastroscopy group （88 cases） and conventional gastroscope group （48 cases）. The preoperative,intraoperative and postoperative heart rate, blood pressure, respiratory, blood oxygen saturation index changes, adverse reactions, bleeding, pain tolerance, and the liver function before operation and 7 days after operation of the two groups were observed. Results In the painless gastroseope group, the preoperative heart rate was significantly faster than those of intraoperation [ （77.4 ± 16.3 ） beat/rain vs （75.6 ± 16.7 ） beat/min ], preoperative systolic pressure and diastolic pressure was significantly higher than that intraoperation[ （192.1 ± 16.6）mmHg vs （105.6 ± 16.2） mmHg; （75.8 ± 8.8 ）mmHg vs （63.7 ± 9.3 ） mmHg ] （P 〈 0.05 ）. In the conventional gastroscopy group, the preoperative heart rate was lower than that of intraoperation [ （ 80.0 ± 16.0） beat/min vs （82.1 ± 15.7 ） beat/min ], the preoperative systolic pressure and diastolic pressure was lower than that of intraoperation [ （ 117.4 ± 20.4） mmHg vs （ 131.0 ± 16.7 ） mmHg; （ 67. 0 ± 12.5 ） mmHg vs （ 73.0 ± 9.0） mmHg ] （ P 〈 0.05 ）. Satisfaction degree of painless gastroscopy group was significantly higher than that of conventional endoscopy group （55.68 % vs 18.75 % ） （P 〈 0.05 ）. Conclusion Painless gastroseopy in the treatment for elderly esophageal varices has the advantages of good curative effect,high safety,clear microscopic vision, less adverse reaction and less pain,therefore,it is worth of further promotion and research.