体位改变在胶囊内镜检查中的作用研究

发布时间：2018-05-11 03:22

本文选题：胶囊内镜 + 体位改变　；参考：《川北医学院》2017年硕士论文

【摘要】：目的:通过改变患者行胶囊内镜时的体位,比较不同体位下胶囊内镜的胃通过时间、小肠通过时间是否有差异,以及是否对全小肠检查完成率、小肠疾病检出率产生影响。探讨体位改变在胶囊内镜检查中的应用价值。方法:选取2015年6月至2016年12月于川北医学院附属医院胃镜室行胶囊内镜检查的60例患者,其中1例是体检,平时无腹痛、黑便等消化道症状,余59例患者主要以腹痛、黑便就诊,行胃镜、肠镜、上消化道钡餐检查均未发现病灶。将60例患者随机分为A、B、C组,分别是A组右侧15°半卧位(20例)、B组右侧30°半卧位(20例)、C组右侧卧位(20例)。所有患者均在检查前一天禁食12h,检查前均使用聚乙二醇电解质散剂或磷酸钠盐清洗肠道,所有检查者近期3天内均未使用促胃肠动力药或刺激性的食物。通过计算机记录三组智能胶囊胃内的转运时间、小肠转运时间、全小肠检查完成率、小肠疾病检出率,最后将各组数据汇总统计,分析其相关性。结果:1.右侧15°半卧位与右侧30°半卧位相比,胃通过时间与小肠通过时间有差异,但差异无统计学意义(P0.05);右侧15°半卧位与右侧卧位相比,胃通过时间明显短于右侧卧位,差异有统计学意义(P0.05),小肠通过时间长于右侧卧位,但差异无统计学意义(P0.05);右侧30°半卧位与右侧卧位相比,胃通过时间短于右侧卧位,差异有统计学意义(P0.05),小肠通过时间长于右侧卧位,但差异无统计学意义(P0.05);三组全小肠检查完成率、小肠疾病检出率差异无统计学意义(P0.05)。2.本实验无一例出现因胶囊内镜本身原因所致的并发症,所有患者耐受性好。结论:1.本实验认为抬高体位能更大程度的减少智能胶囊在胃内的通过时间,相对延长小肠内的通过时间,具有较好的临床应用价值。2.本实验中,右侧15°半卧位与右侧30°半卧位相比,虽胃通过时间和小肠通过时间有差异,但差异无统计学意义。因本研究样本量较小,两者之间是否有差异有待进一步研究证实。3.胶囊内镜是一种较灵敏、安全的检查方法,操作简单、方便,患者耐受性好。
[Abstract]:Objective: by changing the posture of patients undergoing capsule endoscopy, the gastric transit time and intestinal transit time of capsule endoscopy were compared under different postures, as well as the complete rate of complete examination of the whole small intestine and the detection rate of small bowel diseases. To explore the application value of position change in capsule endoscopy. Methods: from June 2015 to December 2016, 60 patients were examined with capsule endoscopy in the gastroscopy room of affiliated Hospital of North Sichuan Medical College. One of them was physical examination. There were no abdominal pain, black stool and other digestive tract symptoms. The remaining 59 patients were mainly with abdominal pain. No lesions were found in black stool, gastroscopy, enteroscopy and upper gastrointestinal barium meal examination. 60 patients were randomly divided into two groups: group A (n = 20) with right 15 掳semi-lying position and group B (n = 20) with right 30 掳lateral position and group C (n = 20) with right lateral position. All the patients fasted for 12 hours on the day before the examination. Before the examination, all the patients used polyethylene glycol electrolyte powder or sodium phosphate to clean their intestines. All the examiners did not use gastrointestinal motility drugs or irritating food in the recent 3 days. The gastric transit time, intestinal transit time, complete rate of whole intestinal examination and the detection rate of small intestinal diseases were recorded by computer. Finally, the data of each group were collected and counted, and the correlation between them was analyzed. The result is 1: 1. In the right 15 掳semi-lying position and the right 30 掳semi-lying position, the gastric transit time was significantly shorter than that in the right lateral position, but there was no significant difference in the gastric transit time between the right 15 掳semi-lying position and the right 30 掳semi-lying position, but the difference was not statistically significant (P 0.05), and the gastric transit time in the right 15 掳semi-lying position was significantly shorter than that in the right lateral position. The difference was statistically significant (P 0.05), the passage time of small intestine was longer than that of the right lateral position, but the difference was not significant (P 0.05), the gastric transit time in the right 30 掳semi-lying position was shorter than that in the right lateral position. The difference was statistically significant (P 0.05), the transit time of small intestine was longer than that of right lateral position, but the difference was not statistically significant (P 0.05). None of the patients had complications due to capsule endoscopy and all patients had good tolerance. Conclusion 1. This experiment suggests that elevating posture can reduce the passage time of intelligent capsule in stomach and prolong the passage time of small intestine to a greater extent, which has better clinical application value. In this experiment, the right 15 掳semi-lying position and the right 30 掳semi-lying position had differences in gastric transit time and intestinal transit time, but the difference was not statistically significant. As the sample size of this study is small, whether there is a difference between the two needs further study to confirm. 3. Capsule endoscopy is a sensitive, safe examination method, simple, convenient and patient tolerance.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R574.5

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