广州医药 ›› 2021, Vol. 52 ›› Issue (3): 74-78.DOI: 10.3969/j.issn.1000-8535.2021.03.016

• 论著 • 上一篇    下一篇

无痛镇静在胃镜下上消化道异物取出术中的应用研究

乐有林, 江堤, 廖素环   

  1. 东莞东华医院消化内科(东莞 523000)
  • 收稿日期:2020-12-31 发布日期:2021-11-24

The study of application value of painless gastroscope in the removal of foreign body in upper gastrointestinal tract

YUE Youlin, JIANG Di, LIAO Suhuan   

  1. Department of Gastroenterology, Tung Wah Hospital, Dongguan 523000, China
  • Received:2020-12-31 Published:2021-11-24

摘要: 目的 探讨无痛镇静在胃镜下上消化道异物取出术中的应用价值。方法 回顾分析2017年5月1日—2020年5月1日在东莞东华医院消化内镜中心接受内镜下上消化道异物取出术患者,对其临床资料进行分析,总结比较在无痛镇静下和普通胃镜下上消化道异物取出术两组患者的诊疗效果。结果 共357例患者,行胃镜下异物取出术共372次,其中无痛镇静组99例,普通组273例,其中15例患者在普通胃镜下异物取出术失败改为无痛镇静下胃镜取出术成功取出,最终10人异物未取出转外科或上级医院;在无痛镇静下行胃镜上消化道异物取出术比普通胃镜下异物取出术成功率高(P<0.05),黏膜损伤、出血、穿孔等并发症少(P<0.05),人均费用低(P<0.05);无痛镇静后患者血氧饱和度、血压下降(P<0.05),心率升高(P<0.05),其中老年人影响明显(P<0.05),但不影响患者内镜操作,氟马西尼催醒后心率、血氧饱和度、血压恢复正常(P>0.05)。结论 在无痛镇静下行胃镜上消化道异物取术安全、有效、成功率高、医疗费用少,患者易于接受的好方法,值得推广。

关键词: 无痛胃镜, 异物取出术, 上消化道

Abstract: Objective To explore the application value of painless gastroscope in the removal of foreign body in upper gastrointestinal tract. Methods The study involved patients who visited at the department of endoscopy center at Hospital (Dongguan, China). Retrospective analysis of patients undergoing endoscopic removal of foreign bodies in the upper gastrointestinal tract from May 1, 2017 to May 1, 2020. We analyzed the patients' clinical data and compared the diagnosis and treatment effect between the painless gastroscope group and normal gastroscopy group. Results A total of 357 patients were included, 372 times of removal of foreign body under gastroscope were conducted. A total of 99 cases in painless gastroscope group were treated by painless gastroscope with painless sedation, 273 cases in normal gastroscopy group were treated by normal gastroscopy, among them, 15 cases were failed to removal the foreign body treated by normal gastroscopy, and turned into the painless sedation gastroscopy. Finally, 10 patients with foreign bodies were not removed and transferred to surgical department or higher level hospitals. In the treatment of endoscopic foreign body removal, the success rate of painless gastroscope group was higher (P<0.05), the complication incidence of mucosal injury, bleeding and perforation and cost per capita were lower than that of normal gastroscopy(P<0.05). Following painless sedation, the blood oxygen saturation, blood pressure dropped (P<0.05) and heart rate increased (P<0.05), the effect of the sedatives on the elderly was the most obvious (P<0.05), but it did not affect the patient's endoscopic operation, and the heart rate, blood oxygen saturation and blood pressure (P>0.05) after awakening. Conclusion Painless gastroscope in the removal of foreign body in upper gastrointestinal tract is safe, effective high success rate, less medical cost, and easy for patients to accept, it should be widely applied.

Key words: Painless gastroscope, Foreign body removal, Upper gastrointestinal tract