本文選題：膠囊內(nèi)鏡 + 體位改變��； 參考：《川北醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過改變患者行膠囊內(nèi)鏡時(shí)的體位,比較不同體位下膠囊內(nèi)鏡的胃通過時(shí)間、小腸通過時(shí)間是否有差異,以及是否對(duì)全小腸檢查完成率、小腸疾病檢出率產(chǎn)生影響。探討體位改變?cè)谀z囊內(nèi)鏡檢查中的應(yīng)用價(jià)值。方法:選取2015年6月至2016年12月于川北醫(yī)學(xué)院附屬醫(yī)院胃鏡室行膠囊內(nèi)鏡檢查的60例患者,其中1例是體檢,平時(shí)無腹痛、黑便等消化道癥狀,余59例患者主要以腹痛、黑便就診,行胃鏡、腸鏡、上消化道鋇餐檢查均未發(fā)現(xiàn)病灶。將60例患者隨機(jī)分為A、B、C組,分別是A組右側(cè)15°半臥位(20例)、B組右側(cè)30°半臥位(20例)、C組右側(cè)臥位(20例)。所有患者均在檢查前一天禁食12h,檢查前均使用聚乙二醇電解質(zhì)散劑或磷酸鈉鹽清洗腸道,所有檢查者近期3天內(nèi)均未使用促胃腸動(dòng)力藥或刺激性的食物。通過計(jì)算機(jī)記錄三組智能膠囊胃內(nèi)的轉(zhuǎn)運(yùn)時(shí)間、小腸轉(zhuǎn)運(yùn)時(shí)間、全小腸檢查完成率、小腸疾病檢出率,最后將各組數(shù)據(jù)匯總統(tǒng)計(jì),分析其相關(guān)性。結(jié)果:1.右側(cè)15°半臥位與右側(cè)30°半臥位相比,胃通過時(shí)間與小腸通過時(shí)間有差異,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);右側(cè)15°半臥位與右側(cè)臥位相比,胃通過時(shí)間明顯短于右側(cè)臥位,差異有統(tǒng)計(jì)學(xué)意義(P0.05),小腸通過時(shí)間長(zhǎng)于右側(cè)臥位,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);右側(cè)30°半臥位與右側(cè)臥位相比,胃通過時(shí)間短于右側(cè)臥位,差異有統(tǒng)計(jì)學(xué)意義(P0.05),小腸通過時(shí)間長(zhǎng)于右側(cè)臥位,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);三組全小腸檢查完成率、小腸疾病檢出率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2.本實(shí)驗(yàn)無一例出現(xiàn)因膠囊內(nèi)鏡本身原因所致的并發(fā)癥,所有患者耐受性好。結(jié)論:1.本實(shí)驗(yàn)認(rèn)為抬高體位能更大程度的減少智能膠囊在胃內(nèi)的通過時(shí)間,相對(duì)延長(zhǎng)小腸內(nèi)的通過時(shí)間,具有較好的臨床應(yīng)用價(jià)值。2.本實(shí)驗(yàn)中,右側(cè)15°半臥位與右側(cè)30°半臥位相比,雖胃通過時(shí)間和小腸通過時(shí)間有差異,但差異無統(tǒng)計(jì)學(xué)意義。因本研究樣本量較小,兩者之間是否有差異有待進(jìn)一步研究證實(shí)。3.膠囊內(nèi)鏡是一種較靈敏、安全的檢查方法,操作簡(jiǎn)單、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 擄semi-lying position and group B (n = 20) with right 30 擄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 擄semi-lying position and the right 30 擄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 擄semi-lying position and the right 30 擄semi-lying position, but the difference was not statistically significant (P 0.05), and the gastric transit time in the right 15 擄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 擄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 擄semi-lying position and the right 30 擄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.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R574.5

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