无痛胃镜与普通胃镜产生的气溶胶:定量评估

Aerosols produced by sedated gastroscopy and unsedated gastroscopy:A quantitative evaluation

目的比较无痛胃镜与普通胃镜产生的气溶胶的区别,为患者和内镜医师提供指导。方法选取2021年4月至2021年12月在武汉大学中南医院消化内科接受胃镜检查的患者,随机分入无痛胃镜组(n=102)与普通胃镜组(n=103)。分别在胃镜检查前、中、后使用手持式光学粒子计数器测量一次气溶胶。对无痛胃镜组和普通胃镜组产生的3次气溶胶,进行组内比较和组间比较。记录两组患者的基线特征及相关因素,分析其与胃镜检查产生的气溶胶之间的关系。结果统计分析包括101名进行无痛胃镜检查的患者和103名进行普通胃镜检查的患者。对胃镜检查后和胃镜检查前的气溶胶数目进行比较,无痛胃镜组直径为0.3μm的气溶胶减少了(15.2±23.2)×10^(6)/m^(3),而普通胃镜组增加了(14.7±26.7)×10^(6)/m^(3)(P<0.001);无痛胃镜组直径为0.5μm的气溶胶减少了(2.24±4.07)×10^(6)/m^(3),而普通胃镜组增加了(4.49±7.71)×10^(6)/m^(3)(P<0.001);无痛胃镜组直径为1.0μm的气溶胶减少了(0.438±0.478)×10^(6)/m^(3),而普通胃镜组增加了(0.0334±0.596)×10^(6)/m^(3)(P<0.001)。两组的胃镜检查时长是(294.2±150.6)s vs(429.4±205.4)s(P<0.001);两组患者出现反应性呕吐、打嗝、打鼾的例数是2(2.0%)vs 82(79.6%)(P<0.001)、13(12.9%)vs 48(46.6%)(P<0.001)、6(5.9%)vs 0(0%)(P=0.012)。结论与普通胃镜检查相比,无痛胃镜产生的气溶胶数量更少,因此在新冠肺炎流行期间,推荐患者进行无痛胃镜检查。

Objective To quantify the aerosols produced by sedated gastroscopy and unsedated gastroscopy and provide guidance to patients and endoscopists.Methods Patients who underwent gastroscopy in the Department of Gastroenterology,Central South Hospital of Wuhan University from April 2021 to December 2021 were randomly divided into painless gastroscopy group(n=102)and ordinary gastroscopy group(n=103).The aerosol was measured by hand-held optical particle counter before,during and after gastroscopy.The aerosols(0.3~10.0μm in diameter,for 3 times)produced by painless gastroscopy group and ordinary gastroscopy group were compared within and between groups.The baseline characteristics and related factors of the two groups were recorded,and the relationship between them and the aerosol produced by gastroscopy was analyzed.Results The statistical analysis included 101 patients who underwent painless gastroscopy and 103 patients who underwent ordinary gastroscopy.Comparing the number of aerosols after and before gastroscopy,the aerosols with a diameter of 0.3μm in the painless gastroscopy group decreased by(15.2±23.2)×10^(6)/m^(3)while the ordinary gastroscopy group increased by(14.7±26.7)×10^(6)/m^(3)(P<0.001);Aerosols with a diameter of 0.5μm were reduced in the painless gastroscopy group(2.24±4.07)×10^(6)/m^(3),while the common gastroscopy group increased by(4.49±7.71)×106/m 3(P<0.001);Aerosols with a diameter of 1.0μm decreased by(0.438±0.478)×10^(6)/m^(3)in the painless gastroscopy group,while increased by(0.0334±0.596)×106/m 3 in the ordinary gastroscopy group(P<0.001).The procedure length of the two groups was(294.2±150.6)vs(429.4±205.4)seconds(P<0.001).The number of patients with reflex vomiting,burping,or snoring in the two groups was 2(2.0%)vs 82(79.6%)(P<0.001),13(12.9%)vs 48(46.6%)(P<0.001),and 6(5.9%)vs 0(0%)(P=0.012).Conclusion Painless gastroscopy produces less aerosol.Therefore,patients are recommended to have painless gastroscopy during the prevalence of COVID-19.