使用纸巾对提高胃镜下黏膜清晰度的效果评价

Application of tissue in gastroscopic examination

目的探讨胃镜检查术前应用纸巾对胃黏膜清晰度、胃镜检查时间及微小病变检出的影响。方法纳入2018年1-3月在山东省千佛山医院接受胃镜检查的患者,采用前瞻性随机对照研究,按随机数字表法将患者随机分为试验组(给予纸巾)及对照组(未给予纸巾)。采用t检验比较试验组和对照组患者年龄,胃镜检查胃底、胃体、胃窦黏膜及胃黏膜总体的黏膜清晰度评分,胃镜检查时间。采用χ^2检验分析两组患者性别、文化程度、胃镜检查原因、是否进行麻醉、是否进行肠镜检查、检出微小病变情况、各部位活检病理情况等的分布情况。结果共纳入患者656例,其中试验组351例,对照组305例。两组患者在年龄、性别、文化程度、胃镜检查原因、是否麻醉、是否行肠镜检查等方面差异均无统计学意义(P均>0.05)。试验组患者胃底、胃体、胃窦黏膜清晰度评分及胃黏膜总体清晰度评分均明显低于对照组,差异具有统计学意义[(1.58±0.72)分vs(2.53±0.83)分,t=0.057,P<0.001;(1.57±0.74)分vs(2.50±0.85)分,t=0.083,P<0.001;(1.54±0.74)分vs(2.51±0.83)分,t=0.082,P<0.001;(4.69±2.07)分vs(7.54±2.43)分,t=0.017,P<0.001]。试验组胃镜检查时间较对照组明显缩短,差异有统计学意义[(6.21±0.37)minvs(6.78±0.65)min,t=-8.78,P<0.001]。试验组检出微小病变数量明显多于对照组,差异有统计学意义(198处vs92处,χ^2=9.361,P=0.009)。试验组患者经胃镜行活检病理检查的胃部组织数量明显多于对照组,差异有统计学意义(166处vs78处,χ^2=5.112,P=0.029);试验组患者与对照组患者经胃镜行活检病理检查的食管和十二指肠组织数量差异无统计学意义(P均>0.05)。结论胃镜检查术前使用纸巾可以明显提高胃黏膜清晰度,缩短胃镜检查时间,促进微小病变的检出,有效提高胃镜检查的准确性,是一种简便、经济的术前准备方法。

Objective To study the effect of normal tissue as a preoperative preparation on gastric mucosal visibility,operation time,and micro-lesion detection during gastroscopic examination. Methods Patients who underwent gastroscopy at Shandong Provincial Qianfoshan Hospital between January 2018 and March 2018 were enrolled in this prospective,randomized controlled trial,and they were divided randomly into either an experimental group (given tissue) or a control group (no tissue given).Gastric mucosal visibility,operation time,micro-lesion detection,and pathological biopsy were compared between the two groups.Results Among the 656 patients included,351 were divided into the experimental group, and 305 were divided into the control group.The scores of gastric mucosal visibility in the fundus,body,and antrum as well as the total score in the experimental group were significantly lower than that in the control group [(1.58±0.72) vs (2.53±0.83),t=0.057,P < 0.001;(1.57±0.74) vs (2.50±0.85),t=0.083,P < 0.001;(1.54±0.74) vs (2.51±0.83),t=0.082,P < 0.001;(4.69±2.07) vs (7.54±2.43),t=0.017,P < 0.001]. Operation time was significantly shorter in the experimental group than in the control group [(6.21±0.37) min vs (6.78±0.65) min,t=-8.78,P < 0.001].There were 198 and 92 micro-lesions that were detected in the experimental group and control group,respectively,and the number of micro-lesions in the experimental group were improved compared with the control group (χ^2=9.361,P=0.009).For biopsy pathology,the number of gastric lesions in the experimental group was significantly higher than that in the control group (166 vs 78,χ^2=5.112,P=0.029).The number for esophageal and duodenal lesions between the two groups had no significant difference (P > 0.05).Conclusion Use of normal tissue could enhance mucosal visibility,shorten the time of examination,is conducive to the detection of micro-lesions,and improve the accuracy of gastroscopy effectively.The normal tissue is a kind of simple and economical method for preoperative preparation.