目的 分析不同胃黏膜准备方案对无痛胃镜检查质量的影响，为制订胃黏膜准备方案提供参考。 方法 采用前瞻性、随机对照研究方法，便利抽样选取2021年3月至2022年12月在山西省运城市中心医院接受无痛胃镜检查的150例患者为研究对象，按照随机数字表法分为对照组、清水组和苏打水组，每组50例。3组患者均于检查前口服链霉蛋白酶+二甲硅油+碳酸氢钠溶液。对照组：检查前4 h禁饮；清水组：检查前2 h饮用纯净水200 ml；苏打水组：检查前2 h饮用苏打水200 ml。比较3组患者胃黏膜清晰度评分以及微小病灶检出率。 结果 对照组男28例，女22例，年龄（47.62 ± 13.83）岁；清水组男30例，女20例，年龄（44.68 ± 13.61）岁；苏打水组男24例，女26例，年龄（46.92 ± 12.79）岁。3组患者食管、胃体、胃窦黏膜清晰度评分以及黏膜清晰度总评分比较差异均有统计学意义（F值为3.68～25.75，均P<0.05）。两两比较：对照组食管、胃窦黏膜清晰度评分以及黏膜清晰度总评分分别为（1.87 ± 0.58）、（1.37 ± 0.34）、（6.72 ± 0.92）分，高于清水组的（1.47 ± 0.41）、（1.18 ± 0.31）、（5.97 ± 0.86）分和苏打水组的（1.42 ± 0.41）、（1.02 ± 0.22）、（5.50 ± 0.79）分，差异均有统计学意义（t值为2.67～5.95，均P<0.05）；清水组胃窦黏膜清晰度评分和黏膜清晰度总评分高于苏打水组，差异均有统计学意义（t=7.11、2.71，均P<0.05）；对照组胃体黏膜清晰度评分为（1.98 ± 0.74）分，高于苏打水组的（1.64 ± 0.54）分，差异有统计学意义（t=2.66，P<0.05）。对照组胃镜检查时间、冲洗次数分别为（135.20 ± 21.60） s、（1.37 ± 0.43）次，清水组分别为（115.52 ± 14.74） s、（0.90 ± 0.29）次，苏打水组分别为（107.48 ± 13.02） s、（0.62 ± 0.23）次，对照组高于清水组和苏打水组，清水组高于苏打水组，差异均有统计学意义（t值为2.38～11.40，均P<0.05）。3组微小病灶检出率比较差异均无统计学意义（均P>0.05）。 结论 无痛胃镜检查前2 h饮用苏打水可明显改善患者胃黏膜清晰度，缩短检查时间，减少冲洗次数，但未明显提高微小病灶检出率。 Objective To analyze the effect of different gastric mucosa preparation programs on the quality of painless gastroscopy, so as to provide reference for developing mucosal preparation programs. Methods This was a prospective, randomized controlled study. A total of 150 patients with painless gastroscopy from March 2021 to December 2022 in Shanxi Yuncheng Central Hospital were selected by convenience sampling in this study, they were assigned to control group, water group, and soda water group by random digits table method, each group contained 50 patients. All patients received oral administration of pronase + dimeticone + sodium bicarbonate solution. In addition, control group: prohibited from drinking 4 hours before examination water group: drinking 200 ml of pure water 2 hours before examination and soda water group: drinking 200 ml of soda water 2 hours before examination. The clarity score of gastric mucosa and the detection rate of small lesions were compared among the three groups. Results There were 28 males and 22 females in the control group, aged (47.62 ± 13.83) years old. There were 30 males and 20 females in the water group, aged (44.68 ± 13.61) years old. There were 24 males and 26 females in the soda water group, aged (46.92 ± 12.79) years old. The difference of esophagus, gastric body, gastric antrum and total mucosal clarity scores among the three groups were statistically significant (F values were 3.68-25.75, all P<0.05). Multiple comparison showed that the esophagus, gastric antrum and total mucosal clarity scores were (1.87 ± 0.58), (1.37 ± 0.34), (6.72 ± 0.92) points in the control group, which were higher than (1.47 ± 0.41), (1.18 ± 0.31), (5.97 ± 0.86) points in the water group, and (1.42 ± 0.41), (1.02 ± 0.22), (5.50 ± 0.79) points in the soda water group, the differences were statistically significant (t values were 2.67-5.95, all P<0.05). The gastric antrum and total mucosal clarity scores in the water group were higher than in the soda water group, the differences were statistically significant (t=7.11, 2.71, both P<0.05). The gastric body mucosal clarity score was (1.98 ± 0.74) points in the control group, which was higher than (1.64 ± 0.54) points in the soda water group, the difference was statistically significant (t=2.66, P<0.05). The gastroscopy examination time and flushin times were (135.20 ± 21.60) s and (1.37 ± 0.43) times in the control group, while (115.52 ± 14.74) s, (0.90 ± 0.29) times and (107.48 ± 13.02) s, (0.62 ± 0.23) times in the water group and soda water group, the control group was higher than the water group and the soda water group, and the water group was also higher than the soda water group, the differences were statistically significant (t values were 2.38-11.40, all P<0.05). However, there was no statistically significant difference in the detection rate of small lesions among the three groups (allP>0.05). Conclusions Drinking soda water 2 hours before painless gastroscopy can significantly improve the clarity of patients′gastric mucosa, shorten the examination time and reduce flushing times, but it does not improve the detection rate of small lesions.
Effect of different gastric mucosa preparation programs on the quality of painless gastroscopy
Objective To analyze the effect of different gastric mucosa preparation programs on the quality of painless gastroscopy, so as to provide reference for developing mucosal preparation programs. Methods This was a prospective, randomized controlled study. A total of 150 patients with painless gastroscopy from March 2021 to December 2022 in Shanxi Yuncheng Central Hospital were selected by convenience sampling in this study, they were assigned to control group, water group, and soda water group by random digits table method, each group contained 50 patients. All patients received oral administration of pronase + dimeticone + sodium bicarbonate solution. In addition, control group: prohibited from drinking 4 hours before examination water group: drinking 200 ml of pure water 2 hours before examination and soda water group: drinking 200 ml of soda water 2 hours before examination. The clarity score of gastric mucosa and the detection rate of small lesions were compared among the three groups. Results There were 28 males and 22 females in the control group, aged (47.62 ± 13.83) years old. There were 30 males and 20 females in the water group, aged (44.68 ± 13.61) years old. There were 24 males and 26 females in the soda water group, aged (46.92 ± 12.79) years old. The difference of esophagus, gastric body, gastric antrum and total mucosal clarity scores among the three groups were statistically significant (F values were 3.68-25.75, all P<0.05). Multiple comparison showed that the esophagus, gastric antrum and total mucosal clarity scores were (1.87 ± 0.58), (1.37 ± 0.34), (6.72 ± 0.92) points in the control group, which were higher than (1.47 ± 0.41), (1.18 ± 0.31), (5.97 ± 0.86) points in the water group, and (1.42 ± 0.41), (1.02 ± 0.22), (5.50 ± 0.79) points in the soda water group, the differences were statistically significant (t values were 2.67-5.95, all P<0.05). The gastric antrum and total mucosal clarity scores in the water group were higher than in the soda water group, the differences were statistically significant (t=7.11, 2.71, both P<0.05). The gastric body mucosal clarity score was (1.98 ± 0.74) points in the control group, which was higher than (1.64 ± 0.54) points in the soda water group, the difference was statistically significant (t=2.66, P<0.05). The gastroscopy examination time and flushin times were (135.20 ± 21.60) s and (1.37 ± 0.43) times in the control group, while (115.52 ± 14.74) s, (0.90 ± 0.29) times and (107.48 ± 13.02) s, (0.62 ± 0.23) times in the water group and soda water group, the control group was higher than the water group and the soda water group, and the water group was also higher than the soda water group, the differences were statistically significant (t values were 2.38-11.40, all P<0.05). However, there was no statistically significant difference in the detection rate of small lesions among the three groups (allP>0.05). Conclusions Drinking soda water 2 hours before painless gastroscopy can significantly improve the clarity of patients′gastric mucosa, shorten the examination time and reduce flushing times, but it does not improve the detection rate of small lesions.
万方数据
