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Helicobacter pylori infection may result in poor gastric cleanliness in magnetically controlled capsule gastroscopy examination: A singlecenter retrospective study
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作者 Jingjing Xia Jie Fang +2 位作者 Liying Chen Yange Meng Lin Su 《Laparoscopic, Endoscopic and Robotic Surgery》 2024年第4期147-154,共8页
Objective:Magnetically controlled capsule gastroscopy(MCCG)is an effective method for screening gastric diseases;however,its performance may be affected by gastric cleanliness.We aimed to explore the correlation betwe... Objective:Magnetically controlled capsule gastroscopy(MCCG)is an effective method for screening gastric diseases;however,its performance may be affected by gastric cleanliness.We aimed to explore the correlation between Helicobacter pylori infection and the degree of gastric cleanliness in the MCCG.Methods:This retrospective study enrolled 297 participants from October 2020 to April 2024 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Participant characteristics,MCCG examination results,and(13)C-urea breath test(C13-UBT)results were collected.The gastric cleanliness in MCCG examinations was assessed using a gastric cleanliness score.Binary logistic regression was used to analyze the relationships among participant characteristics,H.pylori infection,and gastric cleanliness.Chi-square tests and Fisher's exact tests were used to analyze the relationships among gastric lesions,H.pylori infection,and gastric cleanliness.Results:Among the participants,24.2%had H.pylori infection,and 17.5%had poor gastric cleanliness.Hypertension(odds ratio[OR]:2.63;95%confidence interval[CI]:1.36e5.09;p?0.004)was associated with a greater likelihood of H.pylori infection.H.pylori infection(OR:3.76;95%CI:1.99e7.09;p<0.001)was an independent risk factor for poor gastric cleanliness in the MCCG.A significant disparity was noted in the prevalence of focal erosions(p<0.001),gastric ulcers(p?0.001),and positive gastric lesions(p?0.027)between the 2 groups with and without H.pylori infection.The proportion of positive gastric lesions was not significantly different between the good gastric cleanliness group and the poor gastric cleanliness group(25.7%vs.21.2%;p?0.490).Conclusion:The findings of this study revealed that H.pylori infection was associated with hypertension.H.pylori infection may lead to poor gastric cleanliness.Institutions are advised to perform C13-UBT before MCCG,and participants should be informed of the risk of poor gastric cleanliness if the results are positive.The decision to perform H.pylori eradication before MCCG should take into account patient willingness and the benefit-to-risk ratio. 展开更多
关键词 Helicobacter pylori Gastric cleanliness C-urea breath test Hypertension Magnetically controlled capsule gastroscopy
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Combination of propofol and dezocine to improve safety and efficacy of anesthesia for gastroscopy and colonoscopy in adults: A randomized, double-blind, controlled trial 被引量:66
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作者 Xue-Ting Li Chao-Qun Ma +1 位作者 Si-Hua Qi Li-Min Zhang 《World Journal of Clinical Cases》 SCIE 2019年第20期3237-3246,共10页
BACKGROUND Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases.However,endoscopy is usually associated with adverse react... BACKGROUND Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases.However,endoscopy is usually associated with adverse reactions such as nervousness,nausea,vomiting,choking cough,and pain.Severe discomfort,such as vomiting,coughing,or body movement,may lead to aggravation of a preexisting condition or even interruption of examination or treatment,especially in some critically ill patients with physiological dysfunction(e.g.,cardiovascular or respiratory disease).The optimal methods for inducing analgesia and sedation in endoscopy are areas of ongoing debate;nevertheless,determining an appropriate regimen of sedation and analgesia is important.AIM To evaluate the effects of propofol combined with dezocine,sufentanil,or fentanyl in painless gastroscopy and colonoscopy.METHODS Four hundred patients were randomly assigned to one of four groups for anesthesia:intravenous dezocine,sufentanil,fentanyl,or saline.Propofol was administered intravenously for induction and maintenance of anesthesia.RESULTS The dosage of propofol in the dezocine group was significantly lower than those in other groups(P<0.01).Bispectral index and Steward score(0-6 points,an unresponsive,immobile patient whose airway requires maintenance to a fully recovered patient)after eye opening in the dezocine group were significantly higher than those in other groups(P<0.01).Awakening time and postoperative pain score(0-10 points,no pain to unbearable pain)in the dezocine group were significantly lower than those in other groups(P<0.01).Mean arterial pressure and pulse oxygen saturation in the dezocine group were significantly more stable at various time points(before dosing,disappearance of eyelash reflex,and wakeup)than those in other groups(P<0.01).The rates of hypopnea,jaw thrust,body movements,and usage of vasoactive drugs in the dezocine group were significantly lower than those in other groups(P<0.01).Additionally,the rates of reflex coughing,nausea,and vomiting were not statistically different between the four groups(P>0.05).CONCLUSION The combination of propofol and dezocine can decrease propofol dosage,reduce the risk for the development of inhibitory effects on the respiratory and cardiovascular systems,increase analgesic effect,decrease body movement,shorten awakening time,and improve awakening quality. 展开更多
关键词 ANESTHESIA DEZOCINE PROPOFOL gastroscopy COLONOSCOPY
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Comparison of two supplemental oxygen methods during gastroscopy with propofol mono-sedation in patients with a normal body mass index 被引量:16
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作者 Liu-Jia-Zi Shao Yi Zou +4 位作者 Fu-Kun Liu Lei Wan Shao-Hua Liu Fang-Xiao Hong Fu-Shan Xue 《World Journal of Gastroenterology》 SCIE CAS 2020年第43期6867-6879,共13页
BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the a... BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during gastroscopy.The lowest SpO2 during gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxemia during gastroscopy with propofol mono-sedation compared with nasal prongs,but causing slight epistaxis in a few patients. 展开更多
关键词 gastroscopy HYPOXEMIA Wei nasal jet tube Nasal cannula Supplemental oxygen Adverse outcomes
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Clinical applicability of gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia 被引量:11
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作者 Jun-Hyung Cho Seong Ran Jeon So-Young Jin 《World Journal of Clinical Cases》 SCIE 2020年第14期2902-2916,共15页
Premalignant gastric lesions such as atrophic gastritis and intestinal metaplasia frequently occur in subjects with long-term Helicobacter pylori(H.pylori)infection.The regular arrangement of collecting venules(RAC)is... Premalignant gastric lesions such as atrophic gastritis and intestinal metaplasia frequently occur in subjects with long-term Helicobacter pylori(H.pylori)infection.The regular arrangement of collecting venules(RAC)is seen in the normal gastric corpus,whereas mucosal swelling and redness without RAC are observed in H.pylori-infected mucosa.Despite successful H.pylori eradication,the presence of atrophic gastritis and/or gastric intestinal metaplasia(GIM)is a risk factor for gastric cancer.With the development of advanced imaging technologies,recent studies have reported the usefulness of narrow-band imaging(NBI)for endoscopic diagnosis of atrophic gastritis and GIM.Using NBI endoscopy with magnification(M-NBI),atrophic gastritis is presented as irregular coiled microvessels and loss of gastric pits.Typical M-NBI endoscopic findings of GIM are a light blue crest and a white opaque substance.Based on the microvascular patterns,fine network,core vascular,and unclear patterns are useful for predicting gastric dysplasia in polypoid lesions.For diagnosis of early gastric cancer(EGC),a systematic classification using M-NBI endoscopy has been proposed on the basis of the presence of a demarcation line and an irregular microvascular/microsurface pattern.Furthermore,M-NBI endoscopy has been found to be more accurate for determining the horizontal margin of EGC compared to conventional endoscopy.In this review,we present up-to-date results on the clinical usefulness of gastroscopy with NBI for the diagnosis of H.pylori gastritis,precancerous gastric lesion,and neoplasia. 展开更多
关键词 gastroscopy Narrow-band imaging MAGNIFICATION Helicobacter pylori Atrophic gastritis Intestinal metaplasia Dysplasia Cancer
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Efficacy of small-volume simethicone given at least 30 min before gastroscopy 被引量:10
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作者 Mingjun Song Andrew Boon Eu Kwek +5 位作者 Ngai Moh Law Jeannie Peng Lan Ong Jessica Yi-Lyn Tan Prem Harichander Thurairajah Daphne Shih Wen Ang Tiing Leong Ang 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 CAS 2016年第4期572-578,共7页
AIMTo evaluate the efficacy of 5 mL simethicone solution in decreasing gastric foam if given at least 30 min before gastroscopy. METHODSThis was a randomized, placebo controlled, endoscopist blinded study performed at... AIMTo evaluate the efficacy of 5 mL simethicone solution in decreasing gastric foam if given at least 30 min before gastroscopy. METHODSThis was a randomized, placebo controlled, endoscopist blinded study performed at Changi General Hospital. Patients were at least 21 years old, had no prior surgical resection of the upper gastrointestinal tract, and scheduled for elective diagnostic gastroscopies. The primary outcome was the total mucosal visibility score (TMVS) which was evaluated using McNally score. The sample size was calculated to be 24 per group (SD 2.4, 80% power, P t test). RESULTSFifty-four patients were randomised to receive either simethicone [1 mL liquid simethicone (100 mg) in 5 mL of water] or placebo (5 mL of water) at least 30 min before their gastroscopy. Six accredited consultants conducted the gastroscopy, and the interobserver agreement of scoring TMVS was good with a Kappa statistic of 0.73. The simethicone group had significantly better mean TMVS compared to placebo (5.78 &plusmn; SD 1.65 vs 8.89 &plusmn; SD 1.97, P CONCLUSIONWith a premedication time of at least 30 min, 5 mL simethicone can significantly decrease gastric foam, decrease the volume of additional flushes, and shorten gastroscopy time. 展开更多
关键词 SIMETHICONE PREMEDICATION gastroscopy Gastric foam
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Study of wrist-ankle acupuncture therapy for optimizing anaesthesia scheme of painless gastroscopy and improving painless gastroscopy related complications 被引量:11
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作者 Li-Yan Zheng Sui-Cai Mi +2 位作者 Ling-Yan Wu Zheng-Jin Xu Hao Lu 《World Journal of Gastrointestinal Endoscopy》 2023年第2期56-63,共8页
BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical ... BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nausea,vomiting,abdominal distension,and abdominal pain was 11%,8%,6%,and 5%,respectively,which was significantly lower than that in the control group(P<0.05).In addition,both the operators and the patients were more satisfied with this examination,with no significant difference between the groups(P>0.05).CONCLUSION Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme,reduces propofol total dose;shortens patient Wakeup time and Self-ambulation time,improves patient compliance and tolerance,is beneficial to clinical application. 展开更多
关键词 Wrist-ankle acupuncture therapy Acupuncture anaesthesia Painless gastroscopy gastroscopy Anaesthesia-related complications
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Influence of propofol or etomidate combined with remifentanil in painless gastroscopy on inflammatory stress response 被引量:1
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作者 Hua Zhang Lian Zhang 《Journal of Hainan Medical University》 2018年第23期67-70,共4页
Objective:To study the influence of propofol or etomidate combined with remifentanil in painless gastroscopy on inflammatory stress response.Methods: 117 patients with suspected gastritis who underwent painless gastro... Objective:To study the influence of propofol or etomidate combined with remifentanil in painless gastroscopy on inflammatory stress response.Methods: 117 patients with suspected gastritis who underwent painless gastroscopy in our hospital between July 2015 and August 2016 were divided into propofol group (n=67) and etomidate group (n=50) according to the anesthesia schemes. Propofol group received propofol combined with remifentanil anesthesia, and etomidate group received etomidate combined with remifentanil anesthesia. The differences in serum levels of inflammatory factors, stress hormones and oxidative stress indicators were compared between the two groups before the examination (T0), immediately after the examination (T1) and 15 min after the examination (T2).Results: At T0, there were no significant differences in serum levels of inflammatory factors, stress hormones or oxidative stress indexes between the two groups (P>0.05). At T1 and T2, serum inflammatory factors IL-1, IL-6 and CRP levels of etomidate group were lower than those of propofol group;serum stress hormones Cor, NE and E levels were lower than those of propofol group;serum oxidation indexes AOPPs and LHP levels were lower than those of propofol group while anti-oxidation indexes CAT and SOD levels were higher than those of propofol group (P<0.05). Conclusion: Etomidate for painless gastroscopy is better than propofol in maintaining depth of anesthesia and reducing operation trauma. 展开更多
关键词 PAINLESS gastroscopy REMIFENTANIL PROPOFOL ETOMIDATE INFLAMMATORY stress
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Effects of propofol combined with different types of opioids on inflammatory stress response in painless gastroscopy 被引量:1
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作者 Tangnuer·Arken 《Journal of Hainan Medical University》 2018年第6期37-41,共5页
Objective:To study the effects of propofol combined with different types of opioids on inflammatory stress response in painless gastroscopy.Methods: Patients who underwent painless gastroscopy in our hospital between ... Objective:To study the effects of propofol combined with different types of opioids on inflammatory stress response in painless gastroscopy.Methods: Patients who underwent painless gastroscopy in our hospital between August 2014 and January 2018 were retrospectively analyzed, divided into those with nalbuphine hydrochloride, dezocine and sufentanil according to different choice of opioids and included in group A, group B and group C of the study respectively. The contents of inflammatory cytokines and oxidative stress products in serum as well as the expression levels of inflammatory pathway molecules and antioxidant pathway molecules in peripheral blood were measured before and 6 h after gastroscopy.Results: HMGB-1, TNF-α, IFN-γ, CRP, MDA, OH- and O2- contents in serum as well as RhoA, ROCK, Wnt3a,β-catenin, JNK, ERK1/2, Nrf2, ARE, HO-1,γ-GCS and Prx1 expression in peripheral blood of three groups of patients after gastroscopy were higher than those before gastroscopy, and HMGB-1, TNF-α, IFN-γ, CRP, MDA, OH- and O2- contents in serum as well as RhoA, ROCK, Wnt3a,β-catenin, JNK and ERK1/2 expression in peripheral blood of group A after gastroscopy were lower than those of group B and group C whereas Nrf2, ARE, HO-1,γ-GCS and Prx1 expression in peripheral blood were higher than those of group B and group C.Conclusion: Propofol combined with nalbuphine hydrochloride can be more effective than dezocine and sufentanil to reduce the inflammatory stress response in painless gastroscopy. 展开更多
关键词 PAINLESS gastroscopy PROPOFOL OPIOIDS INFLAMMATORY RESPONSE Stress RESPONSE
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Impact of a simulation-based induction programme in gastroscopy on trainee outcomes and learning curves 被引量:2
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作者 Keith Siau James Hodson +6 位作者 Peter Neville Jeff Turner Amanda Beale Susi Green Aravinth Murugananthan Paul Dunckley Neil D Hawkes 《World Journal of Gastrointestinal Endoscopy》 2020年第3期98-110,共13页
BACKGROUND Pre-clinical simulation-based training(SBT)in endoscopy has been shown to augment trainee performance in the short-term,but longer-term data are lacking.AIM To assess the impact of a two-day gastroscopy ind... BACKGROUND Pre-clinical simulation-based training(SBT)in endoscopy has been shown to augment trainee performance in the short-term,but longer-term data are lacking.AIM To assess the impact of a two-day gastroscopy induction course combining theory and SBT(Structured PRogramme of INduction and Training–SPRINT)on trainee outcomes over a 16-mo period.METHODS This prospective case-control study compared outcomes between novice SPRINT attendees and controls matched from a United Kingdom training database.Study outcomes comprised:(1)Unassisted D2 intubation rates;(2)Procedural discomfort scores;(3)Sedation practice;(4)Time to 200 procedures;and(5)Time to certification.RESULTS Total 15 cases and 24 controls were included,with mean procedure counts of 10 and 3(P=0.739)pre-SPRINT.Post-SPRINT,no significant differences between the groups were detected in long-term D2 intubation rates(P=0.332)or discomfort scores(P=0.090).However,the cases had a significantly higher rate of unsedated procedures than controls post-SPRINT(58%vs 44%,P=0.018),which was maintained over the subsequent 200 procedures.Cases tended to perform procedures at a greater frequency than controls in the post-SPRINT period(median:16.2 vs 13.8 per mo,P=0.051),resulting in a significantly greater proportion of cases achieving gastroscopy certification by the end of follow up(75% vs 36%,P=0.017).CONCLUSION In this pilot study,attendees of the SPRINT cohort tended to perform more procedures and achieved gastroscopy certification earlier than controls.These data support the role for wider evaluation of pre-clinical induction involving SBT. 展开更多
关键词 gastroscopy ESOPHAGOGASTRODUODENOSCOPY Endoscopy training INDUCTION Competency development SIMULATION
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Effect of dexmedetomidine combined with propofol on stress response and early cognitive function in hypertensive patients undergoing painless gastroscopy 被引量:1
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作者 Yan-Jun Li Jian-Xin Zhang 《Journal of Hainan Medical University》 2017年第17期146-149,共4页
Objective:To investigate the effect of dexmedetomidine combined with propofol on stress response and early cognitive function in hypertensive patients undergoing painless gastroscopy. Methods: A total of 70 cases of h... Objective:To investigate the effect of dexmedetomidine combined with propofol on stress response and early cognitive function in hypertensive patients undergoing painless gastroscopy. Methods: A total of 70 cases of hypertensive patients undergoing painless gastroscopy from March 2016 to March 2017 were selected as the subjects. They were randomly divided into the observation group and the control group. The control group was injected with physiological saline before injection and injected with propofol 2 mg/kg. The observation group was injected with propofol 0.4 g/kg before injection, and 1 mg/kg by intravenous injection of propofol. 2 groups of patients before administration (T0), after administration (T1), gastroscopy (T2), gastroscope examination at the end of the 10 min (T3) collected venous blood, plasma epinephrine by radioimmunoassay (E), norepinephrine (NE), cortisol (COR) levels of T0 records;T1, T2, T3 at the time of breathing (HR), mean arterial pressure (MAP);after 5 min, 30 min, 3 h, 6 h was evaluated with mini mental state examination (MMSE) to evaluate the cognitive function in early stage.Results: 2 groups of patients with T1, NE, COR levels of plasma E and T0 no significant difference, T2, T3, NE, COR and plasma E levels higher than the T0 level, the observation group T2, T3, NE, plasma E COR levels lower than the control group, there was statistical significance the difference between the 2 groups;the control group T1 HR is slower than T0, MAP less than T0, T2, T3 HR faster than T0, MAP is higher than T0, and the observation group HR and MAP each time point did not change significantly between the 2 groups was statistically significant the difference;after 5 min and 30 min compared with the preoperative MMSE score decreased 1 D, 3 h after operation, the 6 h gradually increased, but the observation group after 3 h MMSE score higher than the control group, the difference was statistically significant.Conclusion: Dexmedetomidine combined with propofol can reduce the stress reaction of patients with hypertension during painless gastroscopy, and reduce the early understanding of the occurrence of dysfunction, which is worthy of clinical promotion. 展开更多
关键词 DEXMEDETOMIDINE PROPOFOL HYPERTENSION PAINLESS gastroscopy Stress response Early COGNITIVE function
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Long-term clinical outcomes of lipiodol marking using standard gastroscopy for image-guided radiotherapy of upper gastrointestinal cancers
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作者 Kim Hay Be Richard Khor +8 位作者 Daryl Lim Joon Ben Starvaggi Michael Chao Sweet Ping Ng Michael Ng Leonardo Zorron Cheng Tao Pu Marios Efthymiou Rhys Vaughan Sujievvan Chandran 《World Journal of Gastroenterology》 SCIE CAS 2021年第42期7387-7401,共15页
BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the ... BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the tumor.Recent studies have demonstrated the feasibility of peri-tumor fiducials in enabling even more accurate delineation of target and normal tissue.The use of gold coils as fiducials in gastrointestinal tumors has been extensively studied.However,placement requires expertise and specialized endoscopic ultrasound equipment.This article reports the long-term outcomes of using a standard gastroscopy to inject liquid fiducials for the treatment of oesophageal and gastric tumors with IGRT.AIM To assess the long-term outcomes of liquid fiducial-guided IGRT in a cohort of oesophageal and gastric cancer patients.METHODS A retrospective cohort study of consecutive adults with Oesophagogastric cancers referred for liquid fiducial placement before definitive/neo-adjuvant or palliative IGRT between 2013 and 2021 at a tertiary hospital in Melbourne,Australia was conducted.Up to four liquid fiducials were inserted per patient,each injection consisting of 0.2-0.5mL of a 1:1 mixture of iodized oil(Lipiodol;Aspen Pharmacare)and n-butyl 2-cyanoacrylate(Histoacryl®;B.Braun).A 23-gauge injector(Cook Medical)was used for the injection.All procedures were performed by or under the supervision of a gastroenterologist.Liquid fiducial-based IGRT(LF-IGRT)consisted of computer-assisted direct matching of the fiducial region on cone-beam computerised tomography at the time of radiotherapy.Patients received standard-IGRT(S-IGRT)if fiducial visibility was insufficient,consisting of bone match as a surrogate for tumor position.Radiotherapy was delivered to 54Gy in 30 fractions for curative patients and up to 45Gy in 15 fractions for palliative treatments.RESULTS 52 patients were referred for liquid fiducial placement within the study period.A total of 51 patients underwent liquid fiducial implantation.Of these a total of 31 patients received radiotherapy.Among these,the median age was 77.4 years with a range between 57.5 and 88.8,and 64.5%were male.Twenty-seven out of the 31 patients were able to have LF-IGRT while four had S-IGRT.There were no complications after endoscopic implantation of liquid fiducials in our cohort.The cohort overall survival(OS)post-radiotherapy was 19 mo(range 0 to 87 mo).Whilst the progression-free survival(PFS)post-radiotherapy was 13 mo(range 0 to 74 mo).For those treated with curative intent,the median OS was 22.0 mo(range 0 to 87 mo)with a PFS median of 14.0 mo(range 0 to 74 mo).Grade 3 complication rate post-radiotherapy was 29%.CONCLUSION LF-IGRT is feasible in 87.1%of patients undergoing liquid fiducial placement through standard gastroscopy injection technique.Our cohort has an overall survival of 19 mo and PFS of 13 mo.Further studies are warranted to determine the long-term outcomes of liquid-fiducial based IGRT. 展开更多
关键词 Image-guided radiotherapy LIPIODOL gastroscopy Gastric cancer Oesophageal cancer Fiducial
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Clinical observation on the efficacy and safety of different doses of alfentanil for painless gastroscopy
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作者 ZHANG Jiao CHEN Rui +2 位作者 LI Yuan XIE Hai WANG Shan 《Journal of Hainan Medical University》 CAS 2023年第18期51-55,共5页
Objective:To observe the Effective dose and safety of different doses of alfentanil combined with propofol in painless gastroscopy.Method:240 patients who underwent painless gastric examination from January 2021 to De... Objective:To observe the Effective dose and safety of different doses of alfentanil combined with propofol in painless gastroscopy.Method:240 patients who underwent painless gastric examination from January 2021 to December 2021 were randomly divided into a control group and a different dose group of alfentanil(N1 group,N2 group,N3 group,N4 group,and N5 group,with injection doses of 5,6,7,8,and 10ug/kg,respectively)using a number table method,with 40 patients in each group.The control group was anesthetized with propofol injection,while different dosage groups of alfentanil were anesthetized with different doses of alfentanil combined with propofol.Evaluate the anesthesia effect after the examination is completed.Compare the heart rate(HR),systolic blood pressure(SBP),apnea time,incidence of intolerance to gastroscopy insertion,and adverse reactions in each group.Result:Compared with before administration,SBP and HR in all groups decreased before gastroscopy placement(P<0.01);At 1 minute after gastroscopy insertion,both SBP and HR in the control group increased(P<0.01),while SBP in the N3 and N4 groups decreased(P<0.01),while HR remained unchanged(P>0.05).Both SBP and HR in the N5 group decreased(P<0.01).Compared with before gastroscopy insertion,SBP and HR in the control group,N1,N2,and N3 groups increased 1 minute after gastroscopy insertion(P<0.01),while there was no significant change in SBP and HR in the N4 and N5 groups(P>0.05).The apnea time of different dosage groups of alfentanil was lower than that of the control group(P<0.01),and the apnea time of N5 group was higher than that of N1 group,N2 group,N3 group,and N4 group(P<0.01).There was no significant difference in the Incidence of intolerant reactions during gastroscopy insertion,cough reaction,retching reflex,swallowing reflex and limb movement reaction rate between the six groups(P>0.05);There was no statistically significant difference in the incidence of itching,nausea,vomiting,anxiety,dizziness,drowsiness,diarrhea,and constipation after painless gastroscopy examination among the six groups(P>0.05).Conclusion:The combination of 8ug/kg alfentanil and propofol has a definite anesthesia effect,stable respiratory and circulatory system,and low incidence of adverse reactions when used for painless gastroscopy. 展开更多
关键词 Afentanil Painless gastroscopy EFFECTIVENESS SECURITY Vital signs Adverse reaction
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Effect of gastroscopy combined with laparoscopy on gastric stromal tumors
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作者 Chun-Tao Ma Hai-Ling Zhang Yong-Dong Wang 《Journal of Hainan Medical University》 2020年第18期57-60,共4页
Objective:To analyze the clinical effect of gastroscopy combined with laparoscopy in the treatment of gastric stromal tumors.Methods:From January 2015 to December 2017,53 patients with gastric interstitial tumors were... Objective:To analyze the clinical effect of gastroscopy combined with laparoscopy in the treatment of gastric stromal tumors.Methods:From January 2015 to December 2017,53 patients with gastric interstitial tumors were screened from the patients who were examined or admitted to our hospital.The patients who were not suitable for surgical treatment with gastroscopy and laparoscopy will be selected.As a control group,a total of 21 patients were treated with open surgery;the remaining 32 patients were treated as a study group with gastroscopy combined with laparoscopy.After treatment,analyze intraoperative or postoperative indicators,pathological results,risk of tumor recurrence,and incidence of complications.Results:The operation time in the study group was significantly longer than that in the control group.The blood loss,abdominal drainage volume,exhaust time,analgesic use time,and hospital stay in the study group were significantly shorter than those in the control group,P<0.05,and the differences were statistically significant.There was no difference between the immunohistochemical results and the benign and malignant tumor results in the group,P>0.05,which was not statistically significant;the difference in recurrence risk between the study group and the control group was not significant,P>0.05;the incidence of complications was significantly lower in the study group.In the control group,the difference was significant,P<0.05.Conclusion:Gastroscopy combined with laparoscopy for gastric stromal tumors has a significant effect,is safe and reliable,and is worthy of clinical promotion. 展开更多
关键词 gastroscopy LAPAROSCOPY Gastric stromal tumor
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Clinical Effect of Emergency Gastroscopy on Acute Bleeding of Gastric Cancer
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作者 Li Qi Cong Wang Jun Wang 《Proceedings of Anticancer Research》 2019年第4期9-12,共4页
Objective:To explore the clinical effect of applying emergency gastroscopy in the treatment of patients with acute bleeding of gastric cancer.Methods:A total of 80 patients with upper gastrointestinal bleeding caused ... Objective:To explore the clinical effect of applying emergency gastroscopy in the treatment of patients with acute bleeding of gastric cancer.Methods:A total of 80 patients with upper gastrointestinal bleeding caused by gastric cancer who were admitted in our hospital from December 2017 to December 2018 were selected and recruited.These patients were divided into two groups,namely the control group and experimental group by random number method,and were given conventional drug treatment and emergency gastroscopy treatment respectively.There were 40 patients in each group.The treatment effect and complication rate of the patients in each group were compared.Results:The rate of efficacy of emergency gastroscopy treatment in patients of the experimental group was 95.00%,whereas the rate of efficacy of conventional drug treatment in patients of the control group was 82.50%.The efficacy rate in the experimental group was higher,and the data were significantly different after statistical comparison.Before treatment,the Karnofsky functional status scores of the patients in both control group and experimental group were not significantly different.After treatment,the patients’scores were all improved.Compared with the control group,the experimental group had a higher degree of improvement,and the effect was more significant.There was a statistically significant difference in data between the two groups(P<0.05).Conclusion:Gastroscopy treatment of patients with acute gastrointestinal bleeding caused by gastric cancer can effectively shorten the bleeding time of patients,reduce the incidence of postoperative complications,and have positive impact for the prognosis of patients. 展开更多
关键词 emergency gastroscopy ACUTE BLEEDING from GASTRIC cancer COMPLICATIONS clinical effect
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鼻罩通气在无痛胃镜检查麻醉期间预防呼吸抑制和低氧的效果
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作者 张芳芳 郭姚邑 +4 位作者 姜帆 冯悦 钟艺 史宏伟 斯妍娜 《中国内镜杂志》 2024年第5期1-8,共8页
目的 探讨鼻罩通气在无痛胃镜检查麻醉期间预防呼吸抑制和低氧的效果。方法 选取2022年9月-2023年3月于该院择期行无痛胃镜检查的患者246例,按随机数表法分为鼻导管吸氧组(C组)和鼻罩吸氧组(M组)。C组采用传统鼻导管给氧,M组采用麻醉鼻... 目的 探讨鼻罩通气在无痛胃镜检查麻醉期间预防呼吸抑制和低氧的效果。方法 选取2022年9月-2023年3月于该院择期行无痛胃镜检查的患者246例,按随机数表法分为鼻导管吸氧组(C组)和鼻罩吸氧组(M组)。C组采用传统鼻导管给氧,M组采用麻醉鼻罩给氧。两组患者予以5 L/min预吸氧3 min,麻醉诱导后,待改良警觉/镇静(MOAA/S)评分≤1分时进胃镜。麻醉期间,C组根据经皮动脉血氧饱和度(SpO_2)实施气道干预措施,M组根据呼气末二氧化碳分压(PetCO_2)和SpO_2进行气道干预。记录麻醉过程中亚临床呼吸抑制、低氧和严重低氧的发生率。记录麻醉期间最低SpO_2值,以及抬下颌、面罩加压给氧和气管插管等干预措施实施情况。记录胃镜检查期间的退镜情况。记录入室时(T0)、麻醉诱导后即刻(T1)、胃镜操作结束时(T2)和苏醒5 min时(T3)的平均动脉压(MAP)、心率(HR)和呼吸频率(RR)。记录围手术期不良事件发生情况、麻醉医师满意度和消化内镜医师满意度。结果 与C组比较,M组亚临床呼吸抑制、低氧和严重低氧的发生率明显降低,差异均有统计学意义(P <0.05)。M组麻醉期间SpO_2最低值高于C组,差异有统计学意义(P <0.05)。与C组比较,M组抬下颌和面罩加压给氧实施率明显降低,差异均有统计学意义(P <0.05)。M组因气道干预退镜率低于C组,差异有统计学意义(P <0.05)。与T0时点相比,两组患者T1和T2时点MAP、HR和RR明显下降,差异均有统计学意义(P <0.05)。两组患者不良事件发生率比较,差异无统计学意义(P> 0.05)。M组消化内镜医师满意度高于C组,差异有统计学意义(P <0.05)。结论 与鼻导管吸氧比较,麻醉鼻罩可及时发现胃镜检查时低通气和呼吸抑制情况,降低低氧发生率,提高气道安全性。 展开更多
关键词 胃镜检查 麻醉 鼻罩 呼吸抑制 低氧
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无痛胃镜检查中年龄对丙泊酚用量的影响分析
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作者 李爱梅 杨峰 +2 位作者 尹秋稳 刘海艳 解淑灿 《中国内镜杂志》 2024年第2期49-55,共7页
目的分析无痛胃镜检查中年龄对丙泊酚用量的影响。方法回顾性分析2017年1月-2020年6月该院收治的158例无痛胃镜检查患者的临床资料,依据患者年龄,将其分为青年组(18~44岁,n=57)、中年组(45~59岁,n=51)和老年组(≥60岁,n=50),比较3组患... 目的分析无痛胃镜检查中年龄对丙泊酚用量的影响。方法回顾性分析2017年1月-2020年6月该院收治的158例无痛胃镜检查患者的临床资料,依据患者年龄,将其分为青年组(18~44岁,n=57)、中年组(45~59岁,n=51)和老年组(≥60岁,n=50),比较3组患者麻醉情况和安全性。结果青年组意识消失时,丙泊酚用量和丙泊酚总用量多于中年组和老年组,且中年组多于老年组;青年组平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、经皮动脉血氧饱和度(SpO2)水平高于中年组和老年组,且中年组高于老年组;青年组麻醉起效时间、麻醉恢复时间、定向力恢复时间和离室时间短于中年组和老年组,且中年组短于老年组;老年组气道梗阻发生率、低氧血症发生率、托下颌发生率、面罩通气发生率、心血管不良事件总发生率、镇静相关不良事件总发生率和进镜受阻发生率高于青年组和中年组,进镜顺利发生率低于青年组和中年组,差异均有统计学意义(P<0.05)。结论年龄增长可能会增加无痛胃镜检查中患者的丙泊酚用量,延长麻醉起效时间、麻醉恢复时间、定向力恢复时间和离室时间,增加应激反应和不良反应,临床中对于高龄患者,应当加强监测。 展开更多
关键词 无痛胃镜检查 青年 中年 老年 丙泊酚
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无痛胃镜检查术后咽喉疼痛的发生情况和危险因素分析
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作者 孙超 刘昕 高巨 《中国内镜杂志》 2024年第7期46-55,共10页
目的探讨无痛胃镜检查术后咽喉疼痛的发生情况及其危险因素。方法选取2019年10月-2019年11月于该院内镜中心接受无痛胃镜检查术的连续门诊患者作为研究对象。采用课题组自行编订的调查问卷收集相关信息,从无痛胃镜检查术后24 h开始,每隔... 目的探讨无痛胃镜检查术后咽喉疼痛的发生情况及其危险因素。方法选取2019年10月-2019年11月于该院内镜中心接受无痛胃镜检查术的连续门诊患者作为研究对象。采用课题组自行编订的调查问卷收集相关信息,从无痛胃镜检查术后24 h开始,每隔24 h进行一次电话随访,直至术后咽喉疼痛完全消失;采用数字分级评分法(NRS)评估术后咽喉疼痛严重程度,并记录持续时间;根据是否出现术后咽喉疼痛,将患者分为术后咽喉疼痛组(Ⅰ组)和非术后咽喉疼痛组(Ⅱ组),将两组组间比较差异有统计学意义的因素纳入多因素Logistic回归分析,筛选影响无痛胃镜检查术患者术后咽喉疼痛的独立危险因素。结果共608例患者完成研究,42例发生术后咽喉疼痛,发生率为6.91%,NRS评分为3.00(2.00,4.25)分,持续时间为24.0(10.0,48.0)h,最长时间为192 h(1例)。年龄及前3天疲劳程度是无痛胃镜检查术患者术后咽喉疼痛的独立影响因素:年龄每增加1岁,术后咽喉疼痛发生率减少2.60%;前3天疲劳程度为中度疲劳和重度疲劳,是术后咽喉疼痛的危险因素。结论无痛胃镜检查术后咽喉疼痛问题值得高度重视。年龄每增加1岁,无痛胃镜检查术后咽喉疼痛发生率减少2.60%;前3天疲劳程度为中度疲劳和重度疲劳,是无痛胃镜检查术后咽喉疼痛的危险因素。 展开更多
关键词 胃镜检查术 并发症 术后不适症状 咽喉疼痛 咽喉反流
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血清微RNA-198和微RNA-365联合胃镜检查在慢性萎缩性胃炎诊断中的应用效果
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作者 李光曙 胡芬 钟碧波 《中国内镜杂志》 2024年第6期23-29,共7页
目的分析血清微RNA-198(miRNA-198)和微RNA-365(miRNA-365)联合胃镜检查在慢性萎缩性胃炎(CAG)诊断中的价值。方法选取2022年1月-2023年1月在该院行胃镜检查的患者360例作为研究对象。其中,180例CAG患者为观察组,同期180例慢性非萎缩性... 目的分析血清微RNA-198(miRNA-198)和微RNA-365(miRNA-365)联合胃镜检查在慢性萎缩性胃炎(CAG)诊断中的价值。方法选取2022年1月-2023年1月在该院行胃镜检查的患者360例作为研究对象。其中,180例CAG患者为观察组,同期180例慢性非萎缩性胃炎患者作为对照组。根据CAG患者萎缩程度分为:轻度56例,中度84例,重度40例。患者均经胃镜检查,并采用实时荧光定量聚合酶链反应(qRT-PCR)法,对血清中miRNA-198和miRNA-365的相对表达水平进行检测。绘制受试者操作特征曲线(ROC curve),分析血清miRNA-198和miRNA-365水平对CAG的诊断价值。采用四格表,分析血清miRNA-198和miRNA-365联合胃镜检查对CAG的诊断价值。结果与对照组相比,观察组血清miRNA-198和miRNA-365水平明显降低,且随着萎缩程度的加重,血清miRNA-198和miRNA-365水平依次降低,差异均有统计学意义(P<0.05);血清miRNA-198和miRNA-365水平诊断CAG的曲线下面积(AUC)分别为0.898和0.945,联合胃镜检查诊断CAG的敏感度为98.33%,特异度为81.11%,准确度为89.72%,其诊断效能均高于血清miRNA-198、miRNA-365和胃镜单独诊断。结论CAG患者血清miRNA-198和miRNA-365水平降低,对CAG具有一定的诊断价值,联合胃镜检查,可明显提高CAG的诊断价值。 展开更多
关键词 慢性萎缩性胃炎(CAG) miRNA-198 miRNA-365 胃镜检查 诊断
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酒石酸布托啡诺联合丙泊酚用于无痛胃镜下ESD患者的有效性与安全性观察
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作者 米延起 赵萍 +1 位作者 王凯 梅丽莎 《中国实用医药》 2024年第16期97-100,共4页
目的研究酒石酸布托啡诺联合丙泊酚对无痛胃镜下内镜黏膜下剥离术(ESD)患者的有效性和安全性。方法90例拟行无痛胃镜下ESD治疗患者,采用随机数字表法分为B1组、B2组及S组,每组30例。B1组、B2组分别于丙泊酚麻醉诱导前5 min给予10、20μg... 目的研究酒石酸布托啡诺联合丙泊酚对无痛胃镜下内镜黏膜下剥离术(ESD)患者的有效性和安全性。方法90例拟行无痛胃镜下ESD治疗患者,采用随机数字表法分为B1组、B2组及S组,每组30例。B1组、B2组分别于丙泊酚麻醉诱导前5 min给予10、20μg/kg酒石酸布托啡诺,S组于丙泊酚麻醉诱导前5 min给予等量生理盐水。比较三组的麻醉苏醒时间、丙泊酚用量、体动发生率,麻醉诱导前(T1)、置镜前(T2)、置镜中(T3)、出镜后(T4)的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO_(2)),低氧血症发生率及不良反应发生率。结果B1组麻醉苏醒时间(6.00±0.56)min短于B2组的(6.77±0.37)min、S组的(6.25±0.33)min,B2组麻醉苏醒时间长于S组(P<0.05);B1组、B2组丙泊酚用量分别为(240.65±13.36)、(200.36±14.58)mg,均少于S组的(270.44±17.38)mg,B1组丙泊酚用量多于B2组(P<0.05);实验过程中S组有10例出现体动,B1组出现3例体动、B2组出现2例体动,B1组、B2组体动发生率分别为10.0%、6.7%,低于S组的33.3%(P<0.05)。T1时,三组患者的HR、MAP、SpO_(2)比较,差异无统计学意义(P>0.05)。与T1时比较,三组患者T2、T3、T4时的MAP均下降(P<0.05);但B1组、B2组患者T2时的MAP均高于S组(P<0.05)。与T1时比较,S组患者T2、T3、T4时的HR均下降,B1组、B2组患者T2、T3时的HR均下降(P<0.05);但B1组、B2组患者T2时的HR高于S组(P<0.05)。与T1时比较,三组患者T2、T3时的SpO_(2)均下降(P<0.05);但B1组、B2组患者T2、T3时的SpO_(2)高于S组(P<0.05)。S组低氧血症发生率26.7%(8/30)明显高于B1组的6.7%(2/30)、B2组的3.3%(1/30)(P<0.05);B2组头晕发生率26.7%(8/30)明显高于S组的0、B1组的6.7%(2/30)(P<0.05)。结论10μg/kg酒石酸布托啡诺复合丙泊酚可以安全、有效地应用于无痛胃镜下ESD患者中,有效提升麻醉效果的同时,可减少不良反应的发生。 展开更多
关键词 酒石酸布托啡诺 丙泊酚 胃肠镜 内镜黏膜下剥离术 麻醉效果
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针刺四关穴缓解无痛胃镜诊疗术中并发呃逆疗效观察
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作者 钟玉婷 田克钧 +1 位作者 李盈 赖露明 《上海针灸杂志》 CSCD 2024年第6期599-603,共5页
目的 基于“气逆动膈”理论,观察针刺四关穴缓解无痛胃镜诊疗术中并发呃逆的有效性和安全性。方法 将100例无痛胃镜诊疗术中并发呃逆的患者随机分为治疗组和对照组,每组50例。治疗组采用针刺双侧合谷、太冲穴治疗,对照组不做任何治疗。... 目的 基于“气逆动膈”理论,观察针刺四关穴缓解无痛胃镜诊疗术中并发呃逆的有效性和安全性。方法 将100例无痛胃镜诊疗术中并发呃逆的患者随机分为治疗组和对照组,每组50例。治疗组采用针刺双侧合谷、太冲穴治疗,对照组不做任何治疗。观察并记录两组呃逆持续时间、胃镜治疗时间、麻醉苏醒时间及不同时间点各项血流动力学指标[平均动脉压(mean arterial pressure, MAP)、心率(heart rate, HR)、血氧饱和度(oxygen saturation, SPO_(2))],比较两组临床疗效。结果 治疗组治疗后治愈率和总有效率分别为50.0%和82.0%,明显高于对照组的14.0%和48.0%,两组比较差异均具有统计学意义(P<0.05)。治疗组呃逆持续时间、胃镜治疗时间均明显少于对照组(P<0.05)。两组呃逆开始时SPO_(2)水平均较基础值显著下降(P<0.05)。治疗组施针后5 min和10 min SPO_(2)水平均明显高于对照组,两组比较差异均具有统计学意义(P<0.05)。结论 针刺四关穴治疗无痛胃镜诊疗术中并发呃逆疗效确切,能有效减少患者呃逆持续时间和胃镜治疗时间。 展开更多
关键词 针刺疗法 呃逆 合谷 太冲 手术后并发症 胃镜
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