首页|杓会厌襞运动指导无痛胃镜进镜的随机对照临床研究

杓会厌襞运动指导无痛胃镜进镜的随机对照临床研究

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目的 探讨以杓会厌襞运动为标志指导无痛胃镜进镜的有效性和安全性。方法 选择2022年1-8月择期行无痛胃镜检查的患者200例,其中男92例、女108例,年龄18~60岁,BMI 18~30 kg/m2,美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级。采用随机数字表法将患者分为两组:对照组(C组)和观察组(O组),每组100例。C组患者以睫毛反射消失作为胃镜进镜时机;O组患者以胃镜视野下杓会厌襞不运动作为胃镜进镜时机。胃镜操作期间脑电双频指数(BIS)值持续维持在40~60。主要观察指标:胃镜操作引发的不良反应(体动反应、呛咳、呃逆、喉痉挛等);次要观察指标:两组患者一般资料,入室后(T0)及胃镜进镜(T1)、进镜后3 min(T2)、进镜后6 min(T3)、退镜(T4)时的血氧饱和度(SpO2)、心率(HR)、收缩压(SBP)、舒张压(DBP),药镜时间,胃镜操作时间,术中药物追加情况。结果 最终纳入192例患者,C组99例、O组93例。两组患者一般资料比较差异无统计学意义(P>0。05);与C组比较,O组患者麻醉诱导时环泊酚使用量升高(P<0。05);与C组比较,O组患者体动反应、呛咳、呃逆、总不良反应发生率降低(P<0。05);两组患者组内不同时间点SpO2、HR、SBP、DBP比较,差异无统计学意义(P>0。05)。结论 以杓会厌襞运动为标志指导无痛胃镜进镜安全、有效,能够降低胃镜操作引起的体动反应、呛咳、呃逆等不良反应。胃镜进镜操作时观察杓会厌襞运动简便易行,其可作为一种客观的进镜时机标志,值得在临床推广使用。
A randomized controlled clinical study of plica aryepiglottica movement for guiding painless gastroscopic entry
Objective To explore the effectiveness and safety of guiding painless gastroscopic entry with plica aryepiglottica movement as the mark.Methods A total of 200 patients with elective painless gas-troscopic examination from January 2022 to August 2022 were selected,92 males and 108 female,aged 18-60 years old,BMI 18-30 kg/m2 and ASA grade Ⅰ-Ⅲ.The patients were divided into the two groups:the con-trol group (group C) and observation group (group O) by adopting the random number table method,100 ca-ses in each group.The disappearance of eyelash reflex in the group C served as the entry timing of gastrosco-py,while the plica aryepiglottica non-movement under the gastroscopic view in the group O served as the en-try timing of gastroscopy.The bispectral index (BIS) value during gastroscopic operation persistently main-tained 40-60.The main observation indicators were the adverse reactions caused by gastroscopic operation (body movement reactions,bucking,hiccup,laryngeal spasm,etc.),and the secondary observation indicators were:general data of the two groups,SpO2,HR,SBP and DBP values after entering the room (T0),at the en-try time of gastroscopy (T1),3 min after gastroscopic entry (T2),6 min after gastroscopic entry (T3) and at the time of gastroscopic retraction (T4),and the time of medication to gastroscopy,gastroscopic operation time and intraoperative medication supplementation.Results A total of 192 cases were ultimately included,99 cases in the group C and 93 cases in the group O.There was no statistically significant difference in general da-ta between the two groups (P>0.05);compared with the group C,the use amount of cyclophosphamide dur-ing anesthesia induction in the group O was increased (P<0.05).Compared with the group C,the incidence rates of body movement reaction,bucking,hiccup and total adverse reactions in the group O were decreased (P<0.05);SpO2,HR,SBP and DBP at different time points had no statistically significant differences be-tween the two groups (P>0.05).Conclusion Using the glottic movement as the marker to guide the pain-less gastroscopy entry is effective and safe,and could reduce the adverse reactions such as body movement re-action,bucking and hiccup caused by gastroscopic entry.Observing the plica aryepiglottica movement in the gastrocopic entry operation is simple and easy to perform,which could serve an objective gastroscopic entry timing mark and is worth promoting and using in clinic.

plica aryepiglottica movemententer timingadverse reactionpainless gastroscopic examination

张维亮、蒋强、陈昱洁、苏帆、孙轸、迟永良

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山东中医药大学中医学博士后科研流动站,济南 250355

山东中医药大学附属医院麻醉科,济南 250014

山东中医药大学附属医院消化内科,济南 250014

杓会厌襞运动 进镜时机 不良反应 无痛胃镜检查

山东省自然科学基金面上项目山东省医学会临床科研资金-齐鲁专项2021山东省中医药科技面上项目

ZR2021MH168YXH2022ZX02103M-2023280

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(16)