胃镜检查形式选择依据研究

Study on the basis of the choice of sedated or conventional gastroscopy

目的探讨临床选择普通胃镜或无痛胃镜的参考依据。方法收集2017年3月至2019年10月重庆市潼南区人民医院消化内科和重庆医科大学附属大学城医院消化中心收治的453例胃镜受检者的检查相关资料,按患者自愿选择的检查方式分为普通胃镜组(251例)和无痛胃镜组(202例)。比较2组受检者耐受程度、检查时间、检查费用等。将普通胃镜组受检者按性别及年龄分为男性18~35岁组(42例)、男性>35~<60岁组(41例)、男性≥60岁组(43例)、女性18~35岁组(41例)、女性>35~<60岁组(42例)和女性≥60岁组(42例),比较各组受检者检查耐受程度及检查质量。结果普通胃镜组受检者恶心及呕吐程度评分、消化道挛缩程度评分、躁动发生率均明显高于无痛胃镜组,检查总时间、检查费用均明显低于无痛胃镜组,差异均有统计学意义(P<0.05);2组受检者图片质量评分比较,差异无统计学意义(P>0.05)。普通胃镜组中男性18~35岁组受检者恶心及呕吐程度评分、躁动发生率均明显高于其他各组,普通胃镜组中女性>35~<60岁组受检者恶心及呕吐程度评分明显高于除男性18~35岁组外的其他各组,差异均有统计学意义(P<0.05)。结论患者对无痛胃镜的耐受力较普通胃镜高,但行无痛胃镜花费时间及费用多。二者检查质量无明显差异。受检者对胃镜的耐受能力受年龄、性别的综合影响,不同性别受检者在不同年龄段对胃镜的耐受力不同。青年男性、中年女性胃镜耐受力相对较差,可建议其合理使用无痛胃镜检查,其余患者可考虑使用普通胃镜检查。

Objective To explore the reference basis of the choice of sedated or conventional gastroscopy.Methods 453 patients from Department of Gastroenterology in Chongqing Tongnan District People′s Hospital and University Town Hospital of Chongqing Medical University who were accepted the sedated or conventional gastroscopy from March,2017 to October,2019 were enrolled in the study consecutively to compare their difference on tolerance,time and cost of the examinations.They were divided into conventional group(252 cases)and sedated group(202 cases)according to their examination willingness.The conventional group was divided different groups according to their gender and age:male with 18-35 years old were 42 cases,male with 35-<60 years old were 41 cases,male with≥60 years old were 43 cases,female with 18-35 years old were 41 cases,female with 35-<60 years old were 42 cases,and female with≥60 years old were 42 cases.These groups were compared on their tolerance degree and examination quality.Results The scores on contracture of digestive tract and agitation rate on conventional gastroscopy group were higher than sedated gastroscopy group(P<0.05).Conventional gastroscopy′s total examination time is shorter than sedated group(P>0.05).In the conventional gastroscopy group:nausea score and contracture of digestive tract score in the group of 18-35 years old male were higher than other groups.Its agitation rate was also higher than other groups.nausea and vomit score in the group of 35-60 years old women was higher than other groups except the group of 18-35 years old male(P<0.05).The cost of sedated group was more than conventional group.Conclusion The tolerance of patient accepted sedated gastroscope is higher than that accepted conventional gastroscopy,but sedated gastroscope takes more time and cost.There is no significant difference in the examination quality between sedated gastroscopy and conventional gastroscopy.Age and gender influence the tolerance of patients accepted gastroscopy synthetically.The tolerance of gastroscopy in different age groups is different in different genders.The gastroscope tolerance of young men and middle-aged women is relatively poor.Reasonable use of sedated gastroscopy can be recommended to these patients.