Zaman A, Hapke R, Sahagun G, Katon R M
Department of Medicine, Oregon Health Sciences University, Portland 97210, USA.
Am J Gastroenterol. 1998 Aug;93(8):1260-3. doi: 10.1111/j.1572-0241.1998.00406.x.
The aim of this study was to assess patient tolerance of unsedated routine upper endoscopy using a 6-mm ultrathin (UT) video endoscope (Olympus XGIF-N200H) and to compare its optical quality to a standard endoscope (Olympus GIF100).
A total of 62 outpatients were recruited for unsedated UT endoscopy using topical spray followed by sedated endoscopy using a standard endoscope. After unsedated endoscopy, patients were asked to complete a questionnaire assessing tolerance. When both endoscopies were completed, the endoscopist recorded findings and optical quality of the UT.
Of 62 patients, 19 refused unsedated endoscopy because of anxiety (12), fear of gagging (3), and unwillingness to be study patients (4).
Of 43 patients, 37 (86%) had a complete, unsedated UT exam (five patients did not have a GIF100 exam). During insertion, 60% of the patients reported none/mild discomfort, whereas, during the remainder of the examination, 73% had none/mild discomfort. Of 37 patients, 30 (81%) were willing to undergo future unsedated endoscopy with the UT and they tolerated UT endoscopy better than the patients who were unwilling (none/mild discomfort: 83% vs 29%). Of 43 patients, six (14%) failed UT endoscopy because of severe gagging (all were male, mean age 44 yr). OPTICS: Optical quality was rated as good 84%, 65%, and 78% of the time in the esophagus, stomach, and duodenum, respectively. Optical quality was diminished by excessive fluid and tenacious secretions. The UT missed five of 59 lesions: three hiatal hernias and two gastric erosions.
A total of 69% of outpatients agreed to undergo peroral unsedated endoscopy with a UT endoscope. A total of 86% of patients tolerated a complete unsedated examination, and 81% of these were willing to undergo future unsedated examinations. Diagnostic accuracy of this ultrathin video endoscope was good, with 92% of lesions discovered when compared with a standard instrument.
本研究旨在评估患者对使用6毫米超薄（UT）视频内窥镜（奥林巴斯XGIF-N200H）进行的非镇静常规上消化道内镜检查的耐受性，并将其光学质量与标准内窥镜（奥林巴斯GIF100）进行比较。
共招募了62名门诊患者，先使用局部喷雾进行非镇静UT内镜检查，随后使用标准内窥镜进行镇静内镜检查。非镇静内镜检查后，要求患者完成一份评估耐受性的问卷。当两种内镜检查均完成后，内镜医师记录UT的检查结果和光学质量。
62名患者中，19人因焦虑（12人）、害怕 gagging（3人）和不愿成为研究对象（4人）而拒绝非镇静内镜检查。
43名患者中，37人（86%）完成了完整的非镇静UT检查（5名患者未进行GIF100检查）。插入过程中，60%的患者报告无/轻度不适，而在检查的其余过程中，73%的患者无/轻度不适。37名患者中，30人（81%）愿意在未来接受UT非镇静内镜检查，且他们对UT内镜检查的耐受性优于不愿意的患者（无/轻度不适：83%对29%）。43名患者中，6人（14%）因严重 gagging（均为男性，平均年龄44岁）未能完成UT内镜检查。光学质量：在食管、胃和十二指肠中，光学质量分别在84%、65%和78%的时间内被评为良好。过多的液体和黏稠分泌物会降低光学质量。UT漏诊了59个病变中的5个：3个食管裂孔疝和2个胃糜烂。
共有69%的门诊患者同意接受UT内镜经口非镇静内镜检查。共有86%的患者耐受了完整的非镇静检查，其中81%愿意在未来接受非镇静检查。与标准器械相比，这种超薄视频内窥镜的诊断准确率良好，发现了92%的病变。
