纸巾联合360°水平翻身法在胃镜检查术前准备中的应用  

Application value of paper towel combined with 360° horizontal turning over method in preoperative preparation of gastroscopy

作　　者：张慧[1] 庞秋萍[1] 苏淑芬[1] 张灿玲[1] Zhang Hui;Pang Qiuping;Su Shufen;Zhang Canling(Department of Nursing,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital),Ji′nan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)护理部,济南250014

出　　处：《中国实用护理杂志》2022年第6期456-460,共5页Chinese Journal of Practical Nursing

基　　金：山东省医药卫生科技发展计划面上项目(2017WS282)。

摘　　要：目的探讨胃镜检查术前使用纸巾联合360°水平翻身法对胃镜视野清晰度、操作时间以及微小病变检出的影响, 从而提高消化道早期癌的检出率。方法选取2020年5—10月在山东第一医科大学第一附属医院自愿接受胃镜检查的门诊及住院患者, 采用前瞻性随机对照研究, 按随机数字表法分为试验组(给予纸巾+360°水平翻身)及对照组(常规方法翻身), 最终共纳入患者948例, 其中试验组487例, 对照组461例。对比2组患者胃镜视野清晰度、操作时间、冲洗次数、微小病变的检出以及早期癌的检出情况。结果试验组胃黏膜清晰度评分(胃底、胃体、胃窦、全胃)为(1.61 ± 0.79)、(1.18 ± 0.56)、(1.01 ± 0.36)、(3.20 ± 0.51)分, 明显低于对照组的(2.56 ± 0.82)、(2.01 ± 0.65)、(1.98 ± 1.10)、(5.05 ± 0.89)分, 差异有统计学意义(t值为0.02~0.07, 均P<0.05)。试验组的操作时间为(5.91 ± 0.41)min, 较对照组的(6.80 ± 0.72)min明显缩短, 差异有统计学意义(t=-7.46, P<0.05)。试验组的冲洗次数≥1次67例占13.8%, 较对照组144例占31.2%明显减少, 差异有统计学意义(χ^(2)=54.78, P<0.05)。试验组检出微小病变数为398处, 较对照组的245处多, 差异有统计学意义(χ^(2)=8.43, P<0.05)。试验组胃内癌前病变或早期癌的检出数目为56处, 明显高于对照组的24处, 差异有统计学意义(χ^(2)=6.45, P<0.05)。结论胃镜检查术前纸巾联合360°水平翻身法的应用可以明显提高胃镜视野清晰度、缩短操作时间, 增加微小病变的检出, 有效地提高消化道早期癌的检出率, 是一种简便、实用的术前准备方法。Objective To investigate the effect of paper towel combined with 360°horizontal turning over method on the field of vision,operation time and detection of small lesions before gastroscopy,so as to improve the detection rate of early gastrointestinal cancer.Methods The outpatients and inpatients who voluntarily accepted gastroscopy in the First Affiliated Hospital of Shandong First Medical University from May to October 2020 were enrolled.A prospective randomized controlled study was used.They were divided into the experimental group(paper towel group combined with 360°horizontal turning over)and the control group(routine)according to the random number table.Finally,a total of 948 patients were included,including 487 cases in the experimental group and 461 cases in the control group.The visual field clarity,operation time,rinse times,detection of micro lesions and detection of early cancer of the two groups were compared.Results The scores of gastric mucosa clarity(fundus,body,antrum and whole stomach)in experimental group were(1.61±0.79),(1.18±0.56),(1.01±0.36),(3.20±0.51)points,which were significantly lower than(2.56±0.82),(2.01±0.65),(1.98±1.10),(5.05±0.89)points in control group.The difference was statistically significant(t values were 0.02-0.07,all P<0.05).The operation time of the experimental group was(5.91±0.41)min,which was significantly shorter than(6.80±0.72)min of the control group,and the difference was statistically significant(t=-7.46,P<0.05).The number of flushing in the experimental group was 67 times,accounting for 13.8%,which was significantly lower than 144 times in the control group,accounting for 31.2%,and the difference was statistically significant(χ^(2)=54.78,P<0.05).The number of microlesions in the experimental group was 398 cases,which was higher than 245 cases in the control group.The difference was statistically significant(χ^(2)=8.43,P<0.05).For biopsy pathology,the detection of precancerous lesions or early carcinomas in the experimental group(56 cases)was significan

关 键 词：胃镜 黏膜清晰度 纸巾 翻身 术前准备 

分 类 号：R735[医药卫生—肿瘤]