Krakamp B, Parusel M, Saers T
Medizinische Klinik 1, Kliniken der Stadt Köln, Krankenhaus Merheim.
Dtsch Med Wochenschr. 2004 Jan 16;129(3):82-6. doi: 10.1055/s-2004-816291.
Transnasal gastroscopy (TNG) is the result of ongoing improvements in endoscopic device development. These ultrathin endoscopes are planned to improve patient satisfaction with the endoscopic procedure.
The aim of the current study was to prospectively evaluate the performance and patient acceptance of transnasal gastroscopy.
Sixty-three consecutive patients (40 males, 23 females, mean age 58.5 years) referred for routine upper gastrointestinal endoscopy to our tertiary care referral centre were assigned to one of three groups: first time transnasal gastroscopy (group 1, TNG), first time transoral gastroscopy (group 2, TOG) and transnasal gastroscopy after a previous unsedated transoral gastroscopy (group 3). All examinations were performed without intravenous sedation. Patients answered a standardised questionnaire immediately following the examination.
The three groups of patients did not differ in age, gender or reason for gastroscopy. Investigations performed using transnasal technique were significantly shorter (TNG 8.9 min and 9.2 min vs. TOG 11.9 min, p = 0.011 and p = 0.026, respectively) than those performed in transoral technique. Nosebleeding, albeit not clinically significant, and the urge to wretch were significantly more common in the transnasal technique group (p > 0.001). Patient acceptance tended to score higher in the transnasal technique groups, however not statistically higher. A greater number of patients from group 3 (TNG after previous TOG) would prefer a repeat exam via the transnasal route.
Transnasal gastroscopy represents a possible alternative to the conventional transoral technique. TNG entails less subjective patient discomfort, and patients experienced in both techniques prefer the transnasal route. Shorter examination times and lack of intravenous sedation result in several benefits: no sedation-related complications, shorter post-procedure observation times, and subsequently shorter time off work for patients.
经鼻胃镜检查（TNG）是内镜设备不断改进的成果。这些超薄内镜旨在提高患者对内镜检查的满意度。
本研究的目的是前瞻性评估经鼻胃镜检查的性能和患者接受度。
连续63例因常规上消化道内镜检查转诊至我们三级医疗转诊中心的患者（40例男性，23例女性，平均年龄58.5岁）被分为三组之一：首次经鼻胃镜检查（第1组，TNG）、首次经口胃镜检查（第2组，TOG）以及在先前未使用镇静剂的经口胃镜检查后进行经鼻胃镜检查（第3组）。所有检查均未使用静脉镇静剂。检查结束后，患者立即回答一份标准化问卷。
三组患者在年龄、性别或胃镜检查原因方面无差异。使用经鼻技术进行的检查明显比经口技术进行的检查时间短（TNG分别为8.9分钟和9.2分钟，而TOG为11.9分钟，p分别为0.011和0.026）。鼻出血（尽管无临床意义）和恶心欲吐的感觉在经鼻技术组中明显更常见（p>0.001）。经鼻技术组的患者接受度得分往往更高，但无统计学上的显著差异。第3组（先前TOG后进行TNG）中更多患者更愿意通过经鼻途径进行重复检查。
经鼻胃镜检查是传统经口技术的一种可能替代方法。经鼻胃镜检查使患者主观不适更少，两种技术都有体验的患者更喜欢经鼻途径。检查时间较短且无需静脉镇静带来了诸多益处：无镇静相关并发症、术后观察时间更短，因此患者的误工时间也更短。
