自制防喷溅咬口在普通胃镜检查中的应用效果观察

柴先灯; 杨桂芳; 丁浩; 邹杨; 刘晓昌

doi:10.16766/j.cnki.issn.1674-4152.003138

自制防喷溅咬口在普通胃镜检查中的应用效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003138

安徽医科大学第一附属医院消化内科，安徽合肥 230022

基金项目:

安徽省自然科学基金项目 1908085QH378

详细信息

通讯作者:
刘晓昌，E-mail：liuchenxiaochang@163.com

中图分类号: R473.57 R443.8
计量
- 文章访问数: 215
- HTML全文浏览量: 98
- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2022-12-15
- 网络出版日期: 2023-09-13

Observation on the effect of self-made anti-splash oral pad in general gastroscopy

Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China

摘要

摘要: 目的普通胃镜检查过程中，患者口腔分泌物易流出或喷溅，增加交叉感染的风险，本研究旨在探讨自制防喷溅咬口在临床应用中的安全性和实用效果。方法将2020年10—12月于安徽医科大学第一附属医院接受普通胃镜检查的60例患者通过随机数字表法将其分为观察组(使用自制防喷溅咬口)和对照组(使用常规一次性咬口)，观察2组患者检查前和检查中的血压、心率和血氧饱和度的变化，患者的口腔分泌物流出量、卫生纸上分泌物重量以及患者的满意度。结果 2组患者检查开始后2 min的收缩压、舒张压、心率与检查开始前5 min相比均有轻微升高，检查前后患者的血氧饱和度无明显改变(均P>0.05)；2组间患者的收缩压、舒张压、心率和血氧饱和度比较差异无统计学意义(均P>0.05)。观察组90%以上的分泌物收集到手套中[(16.19±2.15)g]，卫生纸上分泌物量极少[(1.85±0.31)g], 与对照组卫生纸上的分泌物量相比[(17.78±2.53)g]，差异有统计学意义(P < 0.01)。观察组患者的满意度也优于对照组(93.33% vs. 73.33%，P=0.038)。结论在普通胃镜检查过程中，采用自制防喷溅咬口，安全实用，能有效收集检查过程中流出或喷溅出的分泌物，避免因分泌物流出或喷溅所致的交叉感染，临床实践效果显著，且能明显提高患者的满意度，值得进行深入研究和临床推广。
- 普通胃镜 /
- 口腔分泌物 /
- 防喷溅 /
- 一次性咬口 /
- 自制
Abstract: Objective During general gastroscopy, patients ' oral secretions are prone to outflow or splashing, increasing the risk of cross infection. The purpose of this study is to explore the safety and practical effects of self-made anti-splash oral pad in clinical applications. Methods Sixty patients who underwent general gastroscopy in the First Affiliated Hospital of Anhui Medical University from October to December 2020 were randomly divided into observation group (using self-made anti-splash oral pad) and control group (using routine one-time oral pad) by the random digital table method. The changes of blood pressure, heart rate and blood oxygen saturation before and during the examination were observed in the two groups, as well as the outflow of oral secretions, the amount of secretions on lavatory paper and the satisfaction of patients. Results The systolic blood pressure, diastolic blood pressure and heart rate of the two groups were slightly increased 2 minutes after the examination compared with 5 minutes before the examination, and there was no significant change in blood oxygen saturation before and during the examination (all P>0.05). There was no significant difference in systolic blood pressure, diastolic blood pressure, heart rate and blood oxygen saturation between the two groups (all P>0.05). More than 90% of the secretions in the observation group were collected into the gloves [(16.19±2.15) g], and the amount of secretions on the lavatory paper was very little [(1.85±0.31) g]. Compared with the amount of secretions on the lavatory paper in the control group [(17.78±2.53) g], the difference was statistically significant (P < 0.01). The satisfaction of patients in the observation group was also better than that in the control group (93.33% vs. 73.33%, P=0.038). Conclusion In the process of general gastroscopy, the self-made anti-splash oral pad is safe and practical. It can effectively collect the outflow or splashed secretions during the inspection process and avoid cross infection caused by secretions. The clinical practice effect is significant, and it can significantly improve the patient ' s satisfaction. It is worthy of in-depth research and clinical promotion.
- General gastroscope /
- Oral secretion /
- Splash prevention /
- One-time oral pad /
- Self-made

HTML全文

图 1 防喷溅咬口制作过程

注：防喷溅咬口的制作视频可扫二维码观看。

Figure 1. Production process of anti-splash oral pad

下载: 全尺寸图片幻灯片

表 1 2组胃镜下检查患者检查前和检查中血压、心率、血氧饱和度的比较(x±s)

Table 1. Comparison of blood pressure, heart rate and oxygen saturation before and during gastroscopy in 2 groups(x±s)

组别	例数	检查前5 min				检查开始后2 min
组别	例数	收缩压(mmHg)	舒张压(mmHg)	心率(次/min)	氧饱和度(%)	收缩压(mmHg)	舒张压(mmHg)	心率(次/min)	氧饱和度(%)
观察组	30	123.07±9.88	65.20±7.11	78.00±6.77	98.77±1.00	129.70±8.00	81.57±5.47	85.67±6.45	97.17±1.42
对照组	30	126.46±10.21	66.20±7.91	80.77±5.30	98.53±0.97	131.83±9.18	82.90±5.76	88.47±6.18	97.77±1.38
t值		-1.311	-0.515	-1.763	0.913	-0.960	-0.920	-1.717	-1.661
P值		0.195	0.608	0.083	0.365	0.341	0.361	0.091	0.102
注：1 mmHg=0.133 kPa。

下载: 导出CSV

表 2 2组胃镜下检查患者分泌物流出量的比较(x±s, g)

Table 2. Comparison of discharge volume under gastroscopy between the two groups(x±s, g)

组别	例数	卫生纸分泌物量	手套中分泌物量	分泌物总量
观察组	30	1.85±0.31	16.19±2.15	18.04±2.19
对照组	30	17.78±2.53	－	17.78±2.53
t值		-34.300		0.422
P值		< 0.001		0.675
注：－表示无此项。

下载: 导出CSV

参考文献(21)

[1]	李奇, 鞠红岩, 高峰, 等. 普通胃镜检查对患者心肺血管和生理反应的影响[J]. 中国医刊, 2022, 57(12): 1311-1313. doi: 10.3969/j.issn.1008-1070.2022.12.009 LI Q, JU H Y, GAO F, et al. Effect of unsedated digestive endoscopy on cardiopulmonary vessel and physiological response[J]. Chinese Journal of Medicine, 2022, 57(12): 1311-1313. doi: 10.3969/j.issn.1008-1070.2022.12.009
[2]	凌玉环, 王珩. 安徽省某三甲医院患者对无痛胃镜的选择意愿及其影响因素研究[J]. 包头医学院学报, 2022, 38(1): 1-5, 30. https://www.cnki.com.cn/Article/CJFDTOTAL-BTYX202201001.htm LING Y H, WANG H. Study on Patients'Preference for Painless Gastrocopy and Its Influencing Factors in a Tertiary Hospital in Anhui Province[J]. Journal of Baotou Medical College, 2022, 38(1): 1-5, 30. https://www.cnki.com.cn/Article/CJFDTOTAL-BTYX202201001.htm
[3]	康鑫鑫, 王中玉, 周俊飞, 等. 苯磺酸瑞马唑仑联合阿芬太尼在肥胖患者无痛胃镜检查麻醉中的应用[J]. 中华实用诊断与治疗杂志, 2022, 36(7): 744-746. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD202207022.htm KANG X X, WANG Z Y, ZHOU J F, et al. Application of remimazolam besylate combined with alfentanil in painless gastroscopy in obese patients[J]. Journal of Chinese Practical Diagnosis and Therapy, 2022, 36(7): 744-746. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD202207022.htm
[4]	卢林芝, 张志镒, 吴正奇, 等. 镇静镇痛胃镜与普通胃镜在临床检查中的应用效果比较[J]. 中国内镜杂志, 2021, 27(1): 81-85. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ202101016.htm LU L Z, ZHANG Z Y, WU Z Q, et al. Comparison of clinical effect of sedation and analgesia gastroscope and general gastroscope in clinical examination[J]. China Journal of Endoscopy, 2021, 27(1): 81-85. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ202101016.htm
[5]	SOETIKNO R, TEOH A Y B, KALTENBACH T, et al. Considerations in performing endoscopy during The COVID-19 pandemic[J]. Gastrointest Endosc, 2020, 92(1): 176-183. doi: 10.1016/j.gie.2020.03.3758
[6]	CRNKOVIC D, PECO M, GELO J. Correlation between salivary biochemical stress indicators and psychological indicators[J]. Acta Clin Croat, 2018, 57(2): 316-326.
[7]	LI X T, MA C Q, QI S H, et al. Combination of propofol and dezocine to improve safety and efficacy of anesthesia for gastroscopy and colonoscopy in adults: a randomized, double-blind, controlled trial[J]. World J Clin Cases, 2019, 7(20): 3237-3246. doi: 10.12998/wjcc.v7.i20.3237
[8]	胡建美, 赵洁. 新型冠状病毒肺炎疫情防控期间医用护目镜防雾技巧[J]. 护理研究, 2020, 34(4): 573. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202004009.htm HU J M, ZHAO J. Anti-fog skills for medical goggles during the period of prevention and control of corona virus disease 2019[J]. Chinese Nursing Research, 2020, 34(4): 573. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202004009.htm
[9]	宗杰. 护理质量敏感指标对消化内镜感染质控管理的评价及质量持续改进的影响[J]. 护理实践与研究, 2020, 17(21): 124-126. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202021051.htm ZONG J. Effect of nursing quality sensitive indicators on the evaluation of digestive endoscopy infection quality control management and continuous improvement of quality[J]. Nursing Practice and Research, 2020, 17(21): 124-126. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202021051.htm
[10]	LIU Y Y, LIU Y Q, PETRINI M A. Effect of information of patients ' coping style on pregastroscopy anxiety[J]. Gastroenterol Nurs, 2018, 41(1): 47-58.
[11]	黄平, 张筱凤. 胃镜前口服用药的研究进展[J]. 中国内镜杂志, 2020, 26(6): 83-88. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ202006016.htm HUANG P, ZHANG X F. Research progress of oral medication before gastroscopy examination[J]. China Journal of Endoscopy, 2020, 26(6): 83-88. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ202006016.htm
[12]	王淑芳, 郭艳梅. 基于预见性管理对行常规胃镜检查患者护理质量改善及并发症预防的研究[J]. 中国全科医学, 2021, 24(S2): 200-202. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX2021S2065.htm WANG S F, GUO Y M. Study on the Improvement of Nursing Quality and Prevention of Complications of Patients Undergoing Routine Gastroscopy Based on Predictive Management[J]. Chinese General Practice, 2021, 24(S2): 200-202. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX2021S2065.htm
[13]	宋亚华, 安苗, 秦赟, 等. 消化道症状为主的胃镜检查患者焦虑情绪及影响因素研究[J]. 现代消化及介入诊疗, 2020, 25(10): 1348-1351. https://www.cnki.com.cn/Article/CJFDTOTAL-XDXH202010018.htm SONG Y H, AN M, QIN Y, et al. Study on anxiety and influencing factors in patients with gastrointestinal symptoms undergoing gastroscopy[J]. Modern Digestion & Intervention, 2020, 25(10): 1348-1351. https://www.cnki.com.cn/Article/CJFDTOTAL-XDXH202010018.htm
[14]	钱秋萍, 朱明花, 张晶. 改良体位联合精细化护理对胃镜检查患者配合度、心理状态及不适症状的影响[J]. 护理实践与研究, 2022, 19(18): 2812-2816. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202218027.htm QIAN Q P, ZHU M H, ZHANG J. Effects of improved posture combined with refined nursing on cooperation, psychological state and discomfort symptoms of patients undergoing gastroscopy[J]. Nursing Practice and Research, 2022, 19(18): 2812-2816. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202218027.htm
[15]	王雪飞, 许燕, 祝旭清, 等. 微信群护理干预在无痛胃肠镜检查中的应用效果[J]. 中华全科医学, 2021, 19(4): 698-701. doi: 10.16766/j.cnki.issn.1674-4152.001896 WANG X F, XU Y, ZHU X Q, et al. Application effect of WeChat group nursing intervention on patients undergoing painless gastrointestinal endoscopy procedure[J]. Chinese Journal of General Practice, 2021, 19(4): 698-701. doi: 10.16766/j.cnki.issn.1674-4152.001896
[16]	周春春, 余少敏, 缪国凤, 等. CICARE联合HEART沟通模式在普通胃镜检查患者中的应用[J]. 温州医科大学学报, 2020, 50(12): 1011-1014. https://www.cnki.com.cn/Article/CJFDTOTAL-WZYX202012015.htm ZHOU C C, YU S M, MIAO G F, et al. Application of CICARE and HEART communication mode in patients undergoing ordinary gastroscopy[J]. Journal of Wenzhou Medical University, 2020, 50(12): 1011-1014. https://www.cnki.com.cn/Article/CJFDTOTAL-WZYX202012015.htm
[17]	许多, 金小慧, 吴蕾若, 等. 层次分析法在内镜中心医疗设备精细化管理中的应用[J]. 中华全科医学, 2022, 20(8): 1408-1410, 1441. doi: 10.16766/j.cnki.issn.1674-4152.002609 XU D, JIN X H, WU L R, et al. Application of analytic hierarchy process in refined management of medical equipment in endoscopy center[J]. Chinese Journal of General Practice, 2022, 20(8): 1408-1410, 1441. doi: 10.16766/j.cnki.issn.1674-4152.002609
[18]	张旭, 赵倩, 康晓娜, 等. 新型冠状病毒肺炎疫情下消化内镜中心的感控措施与实践[J]. 西安交通大学学报(医学版), 2021, 42(1): 128-131, 151. https://www.cnki.com.cn/Article/CJFDTOTAL-XAYX202101025.htm ZHANG X, ZHAO Q, KANG X N, et al. Infection control measures and practice in gastrointestinal endoscopy departments during the novel coronavirus infection period[J]. Journal of Xi'an Jiaotong University (Medical Sciences), 2021, 42(1): 128-131, 151. https://www.cnki.com.cn/Article/CJFDTOTAL-XAYX202101025.htm
[19]	杜江, 吴念宏, 李珊, 等. 四川大学华西医院消化内镜中心新型冠状病毒肺炎院内感染防控经验[J]. 中华消化内镜杂志, 2020, 37(3): 156-157, 160. DU J, WU N H, LI S, et al. COVID-19 nosocomial infection prevention and control strategyat West China Hospital, Sichuan University[J]. Chinese Journal of Digestive Endoscopy, 2020, 37(3): 156-157, 160.
[20]	BOR R, SZANTO K J, FABIAN A, et al. Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary: a cross-sectional survey[J]. BMC Gastroenterol, 2021, 21(1): 98.
[21]	杨凤, 陈圆圆, 王彩霞, 等. 基于弹力球的护理干预在常规胃镜检查患者中的应用[J]. 中华现代护理杂志, 2019, 25(11): 1352-1355. YANG F, CHEN Y Y, WANG C X, et al. Application of nursing with bounce ball among patients with routine gastroscopy[J]. Modern Nursing, 2019, 25(11): 1352-1355.