麻醉胃镜检诊食管上段胃黏膜异位症的效果研究

Study on the effect of anesthetic gastroscopy on the diagnosis of heterotopic gastric mucosa in the upper esophagus

目的 研究患者麻醉状态下使用国产澳华AQ-100型内镜对食管上段胃黏膜异位症(HGMUE)进行检诊的效果。方法 选取2018年1月至2020年3月在该院内镜中心进行内镜检查的患者作为研究对象,随机将其分为试验组和对照组。试验组使用澳华AQ-100型胃镜(AQ-100型医用内镜图像处理器和AQL-100型氙灯冷光源),对照组使用Olympus胃镜(GIF-Q260J型),各组受检2000例。遵循自愿原则,另将受检查对象分为无痛组及普通组进行检查,均于进镜至距门齿约15cm处便开始适度注气观察,退镜时于距门齿约25cm处开始充分充气、缓慢退镜(自距门齿约25cm处退镜至距门齿约15cm处,时间大于30s)仔细观察。观察到橘红色、边界清晰的病变区,考虑为异位胃黏膜后,记录其位置、大小、形态、数量,后于可疑病变区中央活检1~2块黏膜组织送病理检验,结合病理结果予以诊断。结果试验组HGMUE阳性检出率为1.80%(36/2000),其中普通组阳性检出率为1.35%(14/1030)、无痛组阳性检出率为2.29%(22/970);对照组HGMUE阳性检出率为2.00%(40/2000),其中普通组阳性检出率为1.67%(13/780)、无痛组阳性检出率为2.21%(27/1220)。试验组和对照组的HGMUE总检出率比较,试验组的无痛组、普通组分别与对照组的无痛组、普通组的HGMUE检出率比较,差异均无统计学意义(P>0.05)。结论 澳华AQ-100型医用胃镜应用价格适中、图像清晰、性能较好,有助于推进我国全面普及内镜检查,尤其是无痛胃镜检查,可提高HGMUE检诊率。

Objective To research the effect of Chinese(AOHUA AQ-100 type)endoscope on the diagnosis of heterotopic gastric mucosa in the upper esophagus(HGMUE)under anesthesia.Methods The patients who underwent endoscopy in the endoscopy center of a hospital from January 2018 to March 2020 were selected as the research objects and randomly divided into the experimental group and the control group.The AOHUA AQ-100 type gastroscope(AQ-100-type medical endoscopic image processor and AQL-100-type xenon cold light source)was used in the experimental group.while the Olympus gastroscope(GIF-Q260J-type)was used in the control group.A total of 2000 cases were examined in each group respectively.The patients were divided into the painless test group and the general test group for examination on a voluntary basis.In each group,moderate air injection observation was started at about 15 cm from the incisor,and then full air injection was started at about 25 cm from the incisor while slowly withdrawing the gastroscope(from about 25cm from the incisor to about 15cm from the incisor for more than 30 seconds),and careful observation was carried out.When the orange-red lesion with a clear boundary was observed,its position,size,shape and quantity were recorded,after considering it as HGMUE.Then,one to two pieces of mucosa were biopsied in the center of the suspected lesion and sent for pathological examination.The diagnosis was made according to the pathological results.Results In the experimental group,the total detection positive rate of HGMUE was 1.80%(36/2000).Among them,the detection positive rate was about 1.35%(14/1030)in the ordinary gastroscope group and 2.29%(22/970)in the painless gastroscope group.In the control group,the total detection positive rate of HGMUE was 2.00%(40/2000).Among them,the detection positive rate was about 1.67%(13/780)in the ordinary gastroscope group and 2.21%(27/1220)in the painless gastroscope group.In this study,there was no significant statistical difference in the total detection positive rate of HGMUE between the experimental group and the control group(P>0.05).There were no significant statistical differences about the positive rate in the painless gastroscope groups and the ordinary group between the experimental group and the control group too.Conclusion The application of the AOHUA AQ-100 medical gastroscope has the advantages of moderate price,clear image and good performance,which is helpful to promote the popularization of endoscopy in our country,especially in painless gastroscopy.It can improve the diagnosis rate of HGMUE.