上消化道内镜检查中的抽吸操作。
Aspiration in the context of upper gastrointestinal endoscopy.
作者信息
Thomson A, Tye-Din J, Tonga S, Scott J, McLaren C, Pavli P, Lomas F
机构信息
Gastroenterology Unit, The Canberra Hospital, The Australian National University Medical School, Canberra, Australia.
出版信息
Can J Gastroenterol. 2007 Apr;21(4):223-5. doi: 10.1155/2007/307937.
BACKGROUND
Pulmonary aspiration is a life-threatening complication of upper gastrointestinal endoscopy, the incidence of which has not been determined. Endoscopy-related aspiration has not been studied in procedures in which patients swallow a radiolabelled potential aspirate immediately before endoscopy and undergo nuclear scanning postprocedure.
METHODS
A pilot study was conducted in which 200 MBq of nonabsorbable technetium-99m phytate in 10 mL of water was administered orally to 50 patients who were about to undergo endoscopy. Gamma camera images were obtained to ensure that there had been no aspiration before endoscopy. After endoscopy, a repeat scan was performed. Fluid aspirated through the endoscope was also collected and analyzed for radioactivity using a hand-held radiation monitor.
RESULTS
No evidence of pulmonary aspiration was found in any of the patients studied. The mean estimated percentage of the initially administered radioactivity aspirated through the endoscope was 2.66% (range 0% to 10.3%).
CONCLUSION
The present pilot study confirms earlier observations that clinically significant aspiration in the context of upper gastrointestinal endoscopy is uncommon. The incidence of aspiration may, however, be different in acutely bleeding patients undergoing endoscopy. For logistic reasons, this group could not be studied.
背景
肺误吸是上消化道内镜检查的一种危及生命的并发症，其发生率尚未确定。在患者于内镜检查前即刻吞咽放射性标记的潜在误吸物并于检查后接受核扫描的操作中，尚未对内镜检查相关的误吸进行研究。
方法
开展一项前瞻性研究，向50例即将接受内镜检查的患者口服10 mL水中含200 MBq不可吸收的99m锝植酸盐。获取γ相机图像以确保内镜检查前无误吸情况。内镜检查后，进行重复扫描。还收集通过内镜吸出的液体，并用手持式辐射监测仪分析其放射性。
结果
在所研究的任何患者中均未发现肺误吸的证据。通过内镜吸出的最初给予的放射性的平均估计百分比为2.66%（范围0%至10.3%）。
结论
本前瞻性研究证实了早期的观察结果，即上消化道内镜检查时具有临床意义的误吸并不常见。然而，在内镜检查的急性出血患者中，误吸的发生率可能有所不同。出于后勤方面的原因，该组患者未纳入研究。
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