无痛内镜检查后患者精神、认知、睡眠、不适反应及其影响因素的研究

THE STUDY OF SPIRIT, COGNITIVE FUNCTION, SLEEP, DISCOMFORT AND ASSOCIATED FACTORS IN PATIENTS UNDERGOING PROCEDURAL SEDATION FOR GASTROINTESTINAL ENDOSCOPY

目的:调查无痛消化内镜检查结束后短期内患者的精神、认知、睡眠及其不适反应可能的影响因素。方法:连续收集在北京大学人民医院消化内镜室行无痛胃肠镜患者,检查后24小时内随访,研究患者的精神、认知、睡眠及不适反应和性别、年龄、麻醉方式、检查种类、操作时间、是否应用咪唑安定以及是否应用氟马西尼等分层因素的关系。结果:无痛消化内镜的总体满意度高(98.3%)。影响精神、认知、记忆和睡眠的危险因素包括:女性、胃镜、操作时间短于15 min以及未使用咪达唑仑。影响躯体不适的危险因素包括:女性、检查种类以及未使用咪达唑仑。结论:无痛消化内镜患者的总体舒适性高,对检查后短期的精神、认知、睡眠无不良影响,还可减少内镜检查相关不适。

Objective： To investigate the spirit, cognitive function, sleep, discomfort of patients undergoing procedural sedation within 24 hrs time period after gastrointestinal endoscopy（GIE） and to analyze the associated factors with these manifestations. Method： Patients undergoing gastroscopy, colonoscopy and gastrointestinal endoscopy with procedural sedation in Endoscopy Care Unit in Peking University People＇s Hospital from 16 th Sep 2012 to 28 th Jun 2014 were enrolled. Follow up was done within 24 hours after the GIE with questionnaire（table 1） through phone calls. Patients were divided according to gender, age, sedation level, endoscopy type, procedure duration, the use of midazolam and the use of flumazenil. The correlation of patients＇ spirit, cognitive function, sleep and discomfort with the factors above were studied. Results： The total satisfaction of procedural sedation for GIE is as high as 98.3% and it varies among gender, age, endoscopy type, procedure duration and the use of midazolam. The risk factors that influencing patients＇ spirit, cognitive function and sleep after GIE include female, gastroscopy, procedure duration less than 15 mins and not using midazolam. The risk factors that influencing patients＇ somatic discomfort include female, endoscopy type and not using midazolam. Conclusion： Procedural sedation shows no adverse effect to patients＇ spirit, cognitive function and sleep within 24 hours after the GIE, which can significantly decrease the incidence of procedure-related discomforts as well. The efficacy and safety of procedural sedation for GIE are satisfactory.