普通胃镜检查中贲门胃底检查顺序的临床研究  

A comparative study on the improvement of cardia&gastric fundus examination sequence in general gastroscopy

作　　者：王伟[1] 陶锋[1] WeiWang;Feng Tao(Department of Gastrointestinal Surgery,Shaoxing People’s Hospital(Shaoxing Hospital,Zhejiang University School of Medicine),Shaoxing,Zhejiang 312000,China)

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)胃肠外科,浙江绍兴312000

出　　处：《中国内镜杂志》2022年第2期28-34,共7页China Journal of Endoscopy

摘　　要：目的探讨贲门胃底部差异化检查顺序在普通胃镜检查中的优缺点,以期为临床筛选更优的胃镜检查方案。方法回顾性分析2021年1月-2021年4月该院行普通胃镜的200例患者的临床资料。根据检查流程中贲门胃底部拍摄顺序的不同,分为前拍组和后拍组,再按照黏液湖胃液多少进行亚分组。比较各组胃镜检查时长、视野清晰度、患者恶心及操作者满意度等指标,分析贲门胃底前拍的应用效果。结果少胃液时,前拍组与后拍组的胃镜时长及各视野清晰度相差不大。多胃液时,前拍组胃镜时长明显较后拍组短(P<0.05),且前拍组胃底、胃体大弯(为胃体前后壁+胃大弯)、胃角小弯(为胃角+胃小弯)的视野清晰度优于后拍组(P<0.05)。前拍组中,多胃液与少胃液的检查时长及视野清晰度比较,差异无统计学意义。后拍组中,多胃液的胃镜时长明显较少胃液长(P<0.05),贲门、胃底和胃体大弯的视野清晰度差于少胃液(P<0.05)。多胃液时,前拍组恶心反应轻于后拍组(P<0.05)。前拍组总体操作者满意度高于后拍组(P<0.05),尤其在多胃液时(P<0.01)。结论贲门胃底前拍方案缩短了胃镜检查时间,改善了胃镜视野清晰度,减小了胃镜运动幅度,减轻了患者恶心等不适体验感,增加了操作者满意度,尤其在胃液较多时更为适用。贲门胃底前拍是一种值得推广的胃镜检查方案。Objective To select a better gastroscopy program by a comparative study of general gastroscopy with differential cardia and gastric fundus examination sequences.Methods The patients with general gastroscopy from January 2021 to April 2021 were divided into pre group and post group according to the examination sequence of cardia and gastric fundus,then divided into subgroups according to the amount of mucus Lake gastric juice.The duration of gastroscopy,visual field clarity,nausea of patients and satisfaction level of operators were compared.The application effect of pre cardia and gastric fundus pathway was analyzed.Results When there was less gastric juice,there was no significant difference in the duration and clarity of gastroscopy between pre and post groups.However,when there was more gastric juice,the duration of gastroscopy in pre group was significantly shorter than that in post group(P<0.05).When there was more gastric juice,visual field clarity of fundus,body of stomach,angular incisures in pre group was better than that in post group(P<0.05).In pre group,there was no significant difference in the duration and clarity of gastroscopy with more or less gastric juice.However,in post group with more gastric juice,the duration of gastroscopy was significantly longer than that with less gastric juice(P<0.05),and visual field clarity of cardia,fundus,body of stomach was worse than that with less gastric juice(P<0.05).When there was more gastric juice,the nausea reaction of pre group was lighter than that of post group(P<0.05).The satisfaction level of pre group was higher than that of post group(P<0.05),especially when there was more gastric juice(P<0.01).Conclusion Pre cardia and gastric fundus pathway shortens the duration of gastroscopy,improves the clarity of visual field,reduces the range of gastroscope movement,reduces the occurrence of discomfort such as nausea,increases the satisfaction level of operators,especially when there are more gastric juice.It is worth promoting.

关 键 词：普通胃镜 贲门 胃底 检查顺序 

分 类 号：R573[医药卫生—消化系统]