新冠病毒感染恢复期患者行无痛胃肠镜序贯检查的分析  

Analysis of patients convalescing from novel coronavirus infection receiv ing sequential gastroenteroscopy

作　　者：郑晓丹 曾庆琴 潘洋 胡浩[3] 王敏[2] 刘杰民[3] ZHENG XiaoDan;ZENG Qingqin;PAN Yang;HU Hao;WANG Min;LIU Jiemin(Guiyang College of Traditional Chinese Medicine,Guiyang Guizhou 550002;The First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine,Guiyang Guizhou 550002;Depart ment of Digestive Endoscopy,Guizhou Provincial People's Hospit al,Guiyang Guizhou 550002)

机构地区：[1]贵阳中医学院,贵州贵阳550002 [2]贵阳中医学院第一附院,贵州贵阳550002 [3]贵州省人民医院消化内镜科,贵州贵阳550002

出　　处：《当代医药论丛》2023年第15期67-69,共3页

基　　金：贵州省高层次创新型人才项目资助(项目编号:黔科合平台人才[2020]6016)。

摘　　要：目的:探讨新冠病毒感染恢复期患者行无痛胃肠镜序贯检查的可行性、安全性。方法:纳入感染新冠病毒后处于恢复期的患者219例(由麻醉医师和内镜医师进行术前评估显示,无胃肠镜检查的绝对禁忌证)。做好充分的术前准备、术中密切监测、术后仔细观察,医护人员在操作过程中应配合默契、操作熟练轻柔,并观察严重并发症(如喉痉挛、严重低氧血症、严重心律失常、吸入性肺炎、呼吸心跳骤停等)的发生情况。结果:219例患者中有8例出现血氧饱和度下降,最低降至80%,紧急给予抬高下颌、畅通气道、加压给氧后,恢复至95%以上。有5例出现呛咳反应,给予适度拍打背部,吸除食管和口腔分泌物后缓解。有2例出现心率下降,最低降至43次/min,考虑是肠镜钩拉引起反射性迷走神经兴奋,给予暂停操作(必要时推注阿托品),待心率恢复正常后,再接着完成操作。所有患者均未出现喉痉挛、严重低氧血症、严重心律失常、吸入性肺炎等严重并发症。结论:新冠病毒感染恢复期患者行无痛胃肠镜序贯检查是安全、可行的,但必须做好充分的术前评估,制订好各种突发情况的应急预案,以保障检查安全。Objective:To investigate the feasibility and safety of sequential painless gastroenteroscopy in convalescent patients with novel coronavirus infection.Methods:A total of 219 patients in recovery after infection with COVID-19 were included(preoperative evaluation by anesthesiologists and endoscopists showed no absolute contraindications for gastroenteroscopy).Adequate preoperative preparation,close monitoring during the operation and careful observation after the operation should be made.Medical staff should cooperate with each other,operate skillfully and gently during the operation,and observe the occurrence of serious complications(such as laryngeal spasm,severe hypoxemia,severe arrhythmia,aspiration pneumonia,respiratory and cardiac arrest,etc.).Results:8 cases of 219 patients had a decrease in oxygen saturation,the lowest drop to 80%,after emergency administration of mandibular elevation,airway obstruction,pressure oxygen,recovery to more than 95%.There were 5 cases of cough reaction,which was relieved after moderate beating on the back and suction of esophageal and oral secretions.The heart rate decreased in 2 cases,with the lowest rate dropping to 43 beats/min.Considering that the intestinal scope hooking caused reflex vagal nerve excitation,the operation was suspended(atropine was injected when necessary),and the operation was continued after the heart rate returned to normal.No serious complications such as laryngeal spasm,severe hypoxemia,severe arrhythmia and aspiration pneumonia occurred in all patients.Conclusion:It is safe and feasible for patients recovering from novel coronavirus infection to undergo sequential gastroenteroscopy,but adequate preoperative evaluation and emergency plans for various emergencies must be made to ensure the safety of the examination.

关 键 词：新冠病毒感染 恢复期 无痛 胃镜检查 肠镜检查 

分 类 号：R44[医药卫生—诊断学]