某三甲医院消化内镜检查对患者心血管和生理反应的影响因素分析

Analysis of cardiovascular and physiological responses and influencing factors in patients with digestive endoscopy

目的探究消化内镜检查对患者心血管以及生理反应的影响因素。方法选取846例采用消化内镜检查的患者作为研究对象,记录入选患者在进行消化内镜检查前、中、后血压、脉搏等心血管反应变化情况以及出现恶心、呕吐、躁动等生理反应情况,根据检查结果分为A组(出现相关心血管、生理反应)、B组(无相关心血管、生理反应)并分析其影响因素。结果患者胃镜检查中收缩压、舒张压、心率均显著高于检查前和检查后,且差异有统计学意义(P<0.05)。患者肠镜检查中收缩压、舒张压、心率均显著低于检查前和检查后,且差异有统计学意义(P<0.05),但胃镜和肠镜检查后与检查前比较,差异均无统计学意义(P>0.05);血氧饱和度各时间段检查差异均无统计学意义(P>0.05)。胃镜检查患者中出现明显恶心(5次以上)361例(64.0%)、呕吐135例(23.9%)、躁动137例(24.3%)、咳嗽94例(16.7%)、疼痛170例(30.1%)。肠镜检查患者中出现明显恶心(5次以上)42例(14.9%)、呕吐33例(11.7%)、躁动85例(30.1%)、疼痛197例(70.0%)。A组患者与B组患者比较女性较多,年龄较大,医师操作年限较短,检查时间较长,患者自身基础疾病占比较多,且差异均有统计学意义(P<0.05)。性别、年龄、医师操作年限、检查时间、基础疾病是出现相关心血管、生理反应的独立影响因素。结论我院进行消化内镜检查的患者均出现不同程度的血压、心率升高或降低和相关生理反应(恶心、呕吐、躁动、疼痛等症状),且主要影响因素以性别、年龄、医师操作年限、检查时间、基础疾病为主。

Objective To investigate cardiovascular and physiological responses and its influencing factors in patients with digestive endoscopy.Methods 846 patients undergoing digestive endoscopy were selected.The cardiovascular responses such as blood pressure and pulse before,during and after digestive endoscopy as well as physiological reactions such as nausea,vomiting,and agitation were recorded.Patients were divided into group A(with responses)and group B(none response)according to the results,and then the related influencing factors were analyzed.Results The systolic blood pressure,diastolic blood pressure and heart rate during the gastroscopy were higher than those of before and after examinations(P<0.05).The systolic blood pressure,diastolic blood pressure and heart rate during the colonoscopy were lower than those of before and after examinations(P<0.05),while no difference was found before and after examinations(P>0.05).There was either no significant difference in blood oxygen saturation at all time intervals(P>0.05).The proportion of nausea more than 5 times,vomiting,agitation,cough and pain were 64.0%(361 cases),23.9%(135 cases),16.7%(94 cases)and 30.1%(170 cases)during the gastroscopy,which were 14.9%(42 cases),11.7%(33 cases),30.1%(85 cases)and 70.0%(197 cases)during the colonoscopy.The proportion of female patients,higher ages,less experienced doctors,longer operation time and fundamental disease of group A was higher than that of the group B(P<0.05).Multivariate logistic regression analysis showed that gender,age,physician experience,examination time,and underlying disease were independent influencing factors related to cardiovascular and physiological responses.Conclusion Patients with digestive endoscopy have experienced different degrees of cardiovascular and physiological responses,accompanied by nausea,vomiting,restlessness,pain and other symptoms,which are mainly influenced by the gender,age of patients,doctor experience,examination time,basic diseases.