| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 98 === Title: Difference between left decubitus and sitting transnasal upper gastrointestinal endoscopy
Background:
In modern gastroenterology, endoscopy had been an important and low-invasive tool to diagnose and treat upper gastrointestinal diseases. Owing to discomfort of patients, it has obstacle for patients to undergo. It is an important issue not only to decrease the discomfort of patients but also keep the quality of diagnosis.
There were many useful methods to be speculated, including sedated endoscopy, capsule endoscopy, virtual endoscopy and ultrathin endoscopy. Compared with conventional sedated peroral upper gastrointestinal endoscopy, unsedated transnasal endscopy has similar overall satisfaction, shorter recovery duration, more rapid for patients to return work and lower cost. Compared with unsedated peroral ultrathin upper gastrointestinal endoscopy, unsedated transnasal ultrathin endoscopy had more patient tolerance, less sympathetic stimulation and more patients’ willing to undergo next exam by similar method.
Laryngologists usually perform laryngoscopy for patients in sitting position. During the procedure, patients watch the monitor, understand what physicians do and may have more satisfaction. Thus, the study compared the satisfaction of patients underwent unsedated transnasal ultrathin uppergastrointestinal endoscopy in sitting position with conventional left decubitus position.
Method and Material:
Patients were enrolled from outpatient clinic of gastrointestinal department in a teaching hospital in Taichung. Enrolled criteria included age between 18 and 70, first endoscopy and suffered from epigastralgia or acid regurgitation…etc. They were divided into two groups randomly. One was unsedated transnasal upper gastrointestinal endoscopy performed in sitting position. The other in left decubitus position. Primary outcome was patients’ satisfaction. Secondary outcome was procedure duration.
Results :
Between Oct. 20008 and Mar. 2009, 85 patients were enrolled. 43 patients were randomly divided into sitting group. 42 patient left decubitus group. There was no significant difference in demographic data, indications and results of exam. The visual analog score of sitting group was 3.11±2.69 and left decubitus group was 2.59±2.54（ p=.371）. Duration of procedure of sitting group was 276±107seconds and left decubitus group was 184±49 seconds（p=.000）.When patients who received rapid urease test or biopsy were excluded, duration of procedure were 245±63 and 179±57seconds（p=.002）respectively.
Conclusion:
The study revealed that diagnostic unsedated transnasal upper gastrointestinal endoscopy performed in sitting position had similar patients’ satisfaction compared with performed in convention left decubitus position but needed more time.
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