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老年患者胃肠内镜检查的风险管理：接受胃肠内镜检查患者的问卷调查。

Risk management for gastrointestinal endoscopy in elderly patients: questionnaire for patients undergoing gastrointestinal endoscopy.

机构信息

Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka 569-8686, Japan.

出版信息

J Clin Biochem Nutr. 2010 Jan;46(1):73-80. doi: 10.3164/jcbn.09-56. Epub 2009 Dec 29.

DOI:10.3164/jcbn.09-56
PMID:20104268
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2803136/
Abstract

More elderly patients now undergo gastrointestinal endoscopy following recent advances in endoscopic techniques. In this study, we conducted a high-risk survey of endoscopies in Japan, using a questionnaire administered prior to upper gastrointestinal tract endoscopy (UGITE), and identified anticholinergic agents and glucagon preparations as high-risk premedication. We also evaluated the cardiovascular effects of anticholinergic agents and glucagon through measurements of plasma levels of human atrial natriuretic peptide (hANP) and human brain natriuretic peptide (hBNP). The subjects were 1480 patients who underwent UGITE. Nurses administered a pre-endoscopy questionnaire, questioning subjects regarding heart disease, hypertension, glaucoma, and urinary difficulties as risk factors for anticholinergic agents, and Diabetes mellitus as a risk factor for glucagon preparations. Evaluation of subjects divided into under 65 and over 65 age groups revealed that in subjects aged 65 and over, risk factors for anticholinergic agents were significantly more high than those for glucagon. Analysis of the cardiovascular effects of anticholinergic agents and glucagon, in the elderly patients showed that hANP levels were significantly higher following administration of anticholinergic agents, but the change was not significant for glucagon premedication. Taking a detailed history before UGITE with the aid of a questionnaire at the same time as informed consent is obtained, is extremely useful in terms of risk management and selection of the appropriate premedication.

摘要

随着内镜技术的最新进展，越来越多的老年患者接受胃肠内镜检查。在这项研究中，我们通过在上消化道内镜检查（UGITE）前进行问卷调查，对日本的内镜检查进行了高危调查，发现抗胆碱能药物和胰高血糖素制剂是高危的术前用药。我们还通过测量血浆人心房利钠肽（hANP）和人脑利钠肽（hBNP）水平来评估抗胆碱能药物和胰高血糖素的心血管效应。研究对象为 1480 名接受 UGITE 的患者。护士在术前检查时发放问卷，询问患者心脏病、高血压、青光眼和排尿困难等是否为抗胆碱能药物的危险因素，以及糖尿病是否为胰高血糖素制剂的危险因素。将患者分为 65 岁以下和 65 岁以上两组进行评估，结果显示 65 岁以上患者使用抗胆碱能药物的危险因素明显高于使用胰高血糖素的患者。对老年患者抗胆碱能药物和胰高血糖素的心血管效应进行分析，结果显示抗胆碱能药物给药后 hANP 水平显著升高，但胰高血糖素预处理后变化不显著。在获得知情同意的同时，通过问卷详细了解 UGITE 前的病史，对于风险管理和选择合适的术前用药非常有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/a13c2bb092e4/jcbn09-56f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/9c21ac0920a1/jcbn09-56f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/2a731df38faf/jcbn09-56f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/6446569ecba4/jcbn09-56f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/c8d34ea9057d/jcbn09-56f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/a13c2bb092e4/jcbn09-56f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/9c21ac0920a1/jcbn09-56f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/2a731df38faf/jcbn09-56f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/6446569ecba4/jcbn09-56f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/c8d34ea9057d/jcbn09-56f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7996/2803136/a13c2bb092e4/jcbn09-56f05.jpg

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