Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Int J Med Sci. 2013 Jul 3;10(9):1085-91. doi: 10.7150/ijms.6003. Print 2013.
Transnasal endoscopy may be used to observe the head and neck part readily without excessive reflexes. We aimed to evaluate the utility and stability of transnasal esophagogastroduodenoscopy (TN-EGD) in comparison with transoral EGD (TO-EGD) for observation of the pharynx.
Prospective study
A total of 497 patients received unsedated TN-EGD with a 5.5 mm diameter endoscope or unsedated TO-EGD with endoscopes of 6.5 mm, 7.9 mm and 9.2 mm diameter. The rate of completion of pharyngeal observation and numbers of gag reflexes and cough reflexes were recorded.
TN-EGD was performed in 175 patients and TO-EGD was performed in 322 patients. Pharyngeal observation was completed in 173 patients (98.9%) in the TN-EGD group and 235 patients (73.2%) in the TO-EGD group, a significant difference (p<0.001). The TN-EGD group had a low rate of occurrence of gag reflex (0.57%), in contrast, 28.3% of the TO-EGD group had a gag reflex, a significant difference (p<0.01). Multivariable analyses revealed that the use of TN-EGD was the only predictive factor for completion of pharyngeal observation (p<0.0001).
TN-EGD is ideally suited to observation of the pharynx by unsedated EGD.
经鼻内镜检查可用于观察头颈部，且不易引起反射。我们旨在评估经鼻胃镜检查（TN-EGD）与经口胃镜检查（TO-EGD）观察咽部的实用性和稳定性。
前瞻性研究
共 497 例患者接受了无镇静的 5.5mm 直径内镜经鼻胃镜检查或无镇静的 6.5mm、7.9mm 和 9.2mm 直径内镜经口胃镜检查。记录咽部观察完成率、咽反射和咳嗽反射次数。
175 例行 TN-EGD，322 例行 TO-EGD。TN-EGD 组咽部观察完成 173 例（98.9%），TO-EGD 组完成 235 例（73.2%），差异有统计学意义（p<0.001）。TN-EGD 组咽反射发生率低（0.57%），而 TO-EGD 组有 28.3%发生咽反射，差异有统计学意义（p<0.01）。多变量分析显示，使用 TN-EGD 是完成咽部观察的唯一预测因素（p<0.0001）。
无镇静的 EGD 中，经鼻胃镜检查非常适合观察咽部。
