Gillian McColl, BSc, MBChB, MRes, MRCS, is Speciality Trainee Registrar, Department of General Surgery, University Hospital Crosshouse, Kilmarnock, Scotland.
Elaine Yeap, MBChB, MSc, FRCS, is Speciality Trainee Registrar, Department of General Surgery, University Hospital Crosshouse, Kilmarnock, Scotland.
Gastroenterol Nurs. 2021;44(2):E24-E28. doi: 10.1097/SGA.0000000000000589.
Esophagogastroduodenoscopy can be uncomfortable and distressing with many patients opting for conscious sedation over topical local anesthetic spray. Transnasal endoscopy is an alternative and we sought to assess how easily it could be introduced to a district general hospital and how acceptable patients found it. Selected patients requiring diagnostic endoscopy were offered transnasal endoscopy with topical nasal anesthetic by clinicians new to transnasal endoscopy but competent at esophagogastroduodenoscopy. Postal feedback questionnaires were used to assess comfort, distress, recollection of periprocedural consultation, and overall experience (visual analog scale 1-10). A total of 213 transnasal endoscopy procedures were undertaken with 207 completed successfully (97.2%). Two patients (0.9%) had self-limiting epistaxis and no patient required admission. One hundred (47%) questionnaires were returned including 98 from those with completed transnasal endoscopy. Thirty-three (33%) had previous esophagogastroduodenoscopy and 28 (85%) reported a preference for transnasal endoscopy. Fifty-eight patients (59%) found transnasal endoscopy comfortable (visual analog scale >6) with 17 reporting discomfort (visual analog scale <5). Seventeen patients found the procedure distressing (visual analog scale >6) but 70 (73%) did not (visual analog scale <5). Eighty-four patients (85.7%) had clear recollection of their procedure (visual analog scale >6) and overall satisfaction was reported as good (visual analog scale >6) by 94.7%. Transnasal endoscopy can be adopted by clinicians competent with conventional esophagogastroduodenoscopy with expectation of high procedure completion rate and low complication rate. Our patients reported high levels of satisfaction with few reporting distress. Perhaps as a consequence, most patients had a clear recollection of their procedure.
食管胃十二指肠镜检查可能会让人感到不适和痛苦，许多患者选择在局部麻醉喷雾的基础上进行清醒镇静。经鼻内镜检查是一种替代方法，我们旨在评估其在地区综合医院中引入的难易程度以及患者对其的接受程度。需要诊断性内镜检查的选定患者由新接触经鼻内镜但擅长食管胃十二指肠镜检查的临床医生提供经鼻内镜检查，并使用局部鼻用麻醉剂。通过邮寄反馈问卷评估舒适度、痛苦程度、对围手术期咨询的回忆以及总体体验（视觉模拟量表 1-10）。共进行了 213 例经鼻内镜检查，其中 207 例成功完成（97.2%）。两名患者（0.9%）出现自限性鼻出血，无患者需要住院治疗。共收回 100 份（47%）问卷，其中包括 98 份来自完成经鼻内镜检查的患者。33 名（33%）患者有以前的食管胃十二指肠镜检查史，28 名（85%）报告更喜欢经鼻内镜检查。58 名患者（59%）认为经鼻内镜检查舒适（视觉模拟量表>6），17 名患者（17%）报告不适（视觉模拟量表<5）。17 名患者认为该程序令人痛苦（视觉模拟量表>6），但 70 名患者（73%）没有（视觉模拟量表<5）。84 名患者（85.7%）对其手术过程有清晰的回忆（视觉模拟量表>6），94.7%的患者报告总体满意度良好（视觉模拟量表>6）。经鼻内镜检查可以由熟练掌握常规食管胃十二指肠镜检查的临床医生采用，预计手术完成率高，并发症发生率低。我们的患者报告满意度很高，很少有报告痛苦的。也许因此，大多数患者对他们的手术过程都有清晰的回忆。
