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Sellick手法用于食管裂孔疝患者无痛胃镜检查的有效性:一项随机自身对照试验。

Effectiveness of the Sellick maneuver for painless gastroscopy in patients with esophageal hiatal hernia: A randomized, self‑control trial.

作者信息

Zhang Li, Shu Lei, Shi Zhaohong, Chen Zhijun

机构信息

Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, Hubei 430022, P.R. China.

Department of Gastroenterology, Wuhan No. 1 Hospital, Wuhan, Hubei 430022, P.R. China.

出版信息

Exp Ther Med. 2023 Sep 21;26(5):519. doi: 10.3892/etm.2023.12218. eCollection 2023 Nov.

Abstract

The Sellick maneuver is used for endotracheal intubation to prevent the occurrence of gastroesophageal reflux. The aim of the present study was to observe the effect of the Sellick maneuver on safety, esophageal closure status, gastric mucosal fold extension status, and positive detection rate of lesions in patients with esophageal hiatal hernia under painless gastroscopy. A total of 40 patients with esophageal hiatal hernia who underwent painless gastroscopy were screened for the use of the Sellick maneuver, in which the operator applied pressure to the cervical cricoid cartilage during the examination. The status of esophageal closure at the are pressed, examination time, gastric mucosal fold extension score, positive rate of lesion detection, and reflux of gastric juice or gastric contents, amongst other parameters were assessed. After using the Sellick maneuver, the state of esophageal closure during gastroscopy was significantly better than the no-Sellick maneuver group (P<0.05), and the extension scores of the greater curvature folds of the gastric body, the lateral folds of the lesser curvature of the gastric body, and the mucosal folds of the fundus were significantly higher than that of the no-Sellick maneuver (all P<0.05). The number of gastric polyps and gastric lesions (gastric ulcers and mucosal hyperplasia, amongst others) examined with the Sellick maneuver was significantly higher than the no-Sellick maneuver group (P<0.01). The Sellick maneuver effectively improved the extension of gastric mucosal folds during gastroscopy in patients with esophageal hiatal hernia, increased the positive detection rate of gastric lesions, and shortened the endoscopy time.

摘要

塞利克手法用于气管插管以防止胃食管反流的发生。本研究的目的是观察塞利克手法对食管裂孔疝患者在无痛胃镜检查下的安全性、食管闭合状态、胃黏膜皱襞伸展状态以及病变阳性检出率的影响。共有40例接受无痛胃镜检查的食管裂孔疝患者被纳入使用塞利克手法的研究,检查过程中操作者对环状软骨施加压力。评估了按压部位的食管闭合状态、检查时间、胃黏膜皱襞伸展评分、病变检出阳性率以及胃液或胃内容物反流等参数。使用塞利克手法后,胃镜检查时的食管闭合状态明显优于未使用塞利克手法组(P<0.05),胃体大弯侧皱襞、胃体小弯侧皱襞及胃底黏膜皱襞的伸展评分均显著高于未使用塞利克手法组(均P<0.05)。使用塞利克手法检查出的胃息肉及胃部病变(如胃溃疡和黏膜增生等)数量明显高于未使用塞利克手法组(P<0.01)。塞利克手法有效改善了食管裂孔疝患者胃镜检查时胃黏膜皱襞的伸展情况,提高了胃部病变的阳性检出率,并缩短了内镜检查时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58bd/10580244/d87403dd669e/etm-26-05-12218-g00.jpg

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