上消化道内镜检查前各种干扰因素的影响：一项前瞻性随机对照研究。
The influence of various distractions prior to upper gastrointestinal endoscopy: a prospective randomized controlled study.
作者信息
Sogabe Masahiro, Okahisa Toshiya, Adachi Yuka, Takehara Masanori, Hamada Shinichi, Okazaki Jun, Fujino Yasuteru, Fukuya Akira, Kagemoto Kaizo, Hirao Akihiro, Okamoto Koichi, Nakasono Masahiko, Takayama Tetsuji
机构信息
Department of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima city, Tokushima, 770-8503, Japan.
Department of Internal Medicine, Shikoku Central Hospital of the Mutual aid Association of Public School teachers, Shikokuchuo, Japan.
出版信息
BMC Gastroenterol. 2018 Aug 29;18(1):132. doi: 10.1186/s12876-018-0859-y.
BACKGROUND
Although many patients still have anxiety about upper gastrointestinal (GI) endoscopy, there have been few reports on the influence of distractions for a person who is going to undergo upper GI endoscopy soon. This study was a prospective randomized controlled study investigating the influence of distractions, such as auditive and visual distractions using subjective and objective assessments including autonomic nervous function prior to upper GI endoscopy.
METHODS
206 subjects who underwent upper GI endoscopy as regular health check-ups were divided randomly into 4 groups prior to upper GI endoscopy; group 1 (control group), group 2 (auditive group), group 3 (visual group), and group 4 (combination group). We measured vital signs, autonomic nervous function, profile of mood state (POMS), and the impression for upper GI endoscopy pre- and post-distraction in the 4 groups.
RESULTS
There was no significant difference in vital signs between 5 and 15 min after sitting in group 1, however, several vital signs in all distraction groups improved significantly after distraction (Pulse rate (P): p < 0.001 in group 4; blood pressure: p < 0.05 in group 2, 3, 4) and the rate of decrease in P and diastolic blood pressure was highest in group 4 (p < 0.001). Several scores of POMS and the impression for upper GI endoscopy post-distraction improved significantly compared to pre-distraction between distraction groups and the satisfaction for distraction was highest in group 4 (p < 0.01). Regarding autonomic nerve function, the low- frequency power/ high- frequency power ratio post-distraction was significantly lower than that pre-distraction in all distraction groups (p < 0.001).
CONCLUSIONS
Although auditive distraction alone and visual distraction alone were effective, a combination distraction was more effective than any other distraction by subjective and objective assessments. These distractions, which were simple and safe, may play an assistive role in the stability of physical and psychological conditions prior to upper GI endoscopy.
TRIAL REGISTRATION
This trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000022801 . Registered on 10 July 2016.
背景
尽管许多患者对上消化道（GI）内镜检查仍存在焦虑情绪，但关于分心对即将接受上消化道内镜检查的人的影响的报道较少。本研究是一项前瞻性随机对照研究，旨在通过主观和客观评估（包括上消化道内镜检查前的自主神经功能）来调查分心（如听觉和视觉分心）的影响。
方法
将206名因定期健康检查而接受上消化道内镜检查的受试者在上消化道内镜检查前随机分为4组；第1组（对照组）、第2组（听觉组）、第3组（视觉组）和第4组（联合组）。我们测量了4组在分心前后的生命体征、自主神经功能、情绪状态剖面图（POMS）以及对上消化道内镜检查的印象。
结果
第1组坐下后5至15分钟时生命体征无显著差异，然而，所有分心组的几个生命体征在分心后均有显著改善（第4组的心率（P）：p < 0.001；血压：第2、3、4组p < 0.05），且第4组心率和舒张压的下降率最高（p < 0.001）。与分心前相比，分心组中POMS的几个得分以及分心后对上消化道内镜检查的印象均有显著改善，且第4组对分心的满意度最高（p < 0.01）。关于自主神经功能，所有分心组分心后的低频功率/高频功率比值均显著低于分心前（p < 0.001）。
结论
尽管单独的听觉分心和单独的视觉分心均有效，但通过主观和客观评估，联合分心比其他任何分心方式都更有效。这些简单且安全的分心方式可能在上消化道内镜检查前对身体和心理状况的稳定起到辅助作用。
试验注册
本试验在大学医院医学信息网络（UMIN）临床试验注册中心注册，注册号为UMIN000022801。于2016年7月10日注册。
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