Seip Birgitte, Huppertz-Hauss Gert, Sauar Jostein, Bretthauer Michael, Hoff Geir
Department of Medicine, Telemark Hospital, Skien, Norway.
Scand J Gastroenterol. 2008 Aug;43(8):1004-11. doi: 10.1080/00365520801958592.
Although oesophagogastroduodenoscopies (OGDs) are associated with few medical complications, substantial pre-procedural anxiety and discomfort during the procedure have been reported. The aims of the present study were to evaluate OGD-related discomfort assessed by the patient and to identify the possibilities for improvement.
All outpatients undergoing OGDs at a single centre during 2004 were eligible for the study. On site, the endoscopy team completed a questionnaire on age of patients, gender and the use of sedation/anaesthesia. After the examination, the patients were given a questionnaire focusing on discomfort during and after the examination. The questionnaire was to be completed at home the following day and returned in a prepaid envelope.
During the study period, 1283 examinations were registered, giving 92% coverage of OGDs. The patient response rate was 80%. Patients' mean age was 55 years, and 45% were men. The sedation rate was 7.3%. None or only slight discomfort was experienced by 68% of the patients and severe discomfort by 14%. In patients, the odds ratio (OR) for experiencing moderate or severe discomfort decreased with increasing age (OR 0.96, 95% CI 0.95-0.97, p < 0.001). There were significant differences in patient discomfort depending on the level of experience of the endoscopists.
The majority of patients reported no or only slight discomfort during the examination, but as many as 32% did not. Increased use of sedation in selected patients is recommended. Our quality assurance program included a limited number of variables for registration, with satisfactory compliance by endoscopists and patients.
尽管食管胃十二指肠镜检查（OGD）相关的医学并发症较少，但已有报道称患者在检查前会出现严重焦虑，检查过程中也会感到不适。本研究的目的是评估患者评估的与OGD相关的不适，并确定改进的可能性。
2004年在单一中心接受OGD检查的所有门诊患者均符合研究条件。在内镜检查现场，内镜检查团队填写了一份关于患者年龄、性别以及镇静/麻醉使用情况的问卷。检查结束后，向患者发放一份问卷，重点关注检查期间及检查后的不适情况。问卷需在次日在家中完成，并通过预付邮资的信封寄回。
在研究期间，共登记了1283例检查，OGD检查覆盖率为92%。患者的回复率为80%。患者的平均年龄为55岁，45%为男性。镇静率为7.3%。68%的患者未感到不适或仅感到轻微不适，14%的患者感到严重不适。在患者中，出现中度或重度不适的比值比（OR）随年龄增长而降低（OR 0.96，95%可信区间0.95 - 0.97，p < 0.001）。根据内镜医师的经验水平，患者的不适程度存在显著差异。
大多数患者在检查期间报告无不适或仅感到轻微不适，但仍有多达32%的患者并非如此。建议在特定患者中增加镇静剂的使用。我们的质量保证计划纳入了数量有限的登记变量，内镜医师和患者的依从性令人满意。
