摘要
目的:调查消化内镜检查患者的精神状况和疼痛、不适反应,分析其可能的影响因素,为选择性干预治疗提供临床依据。方法:连续收集1527例行消化内镜检查患者的资料,应用焦虑自评量表(SAS)、视觉模拟评分(VAS)对患者的焦虑和疼痛、不适程度进行评估,并记录其围检查期的血压、脉搏。依据患者的性别、年龄、文化程度、既往检查史、焦虑程度、内镜医师的操作经验及检查项目进行分组研究。结果:内镜检查患者存在着不同程度的焦虑、疼痛和不适。SAS总粗分平均31.50±8.47分,高于国内常模(29.78±10.07分),女性比男性焦虑程度高(P<0.0001),高中文化程度的焦虑程度最高(P=0.026)。胃镜检查以不适为主,尤以插镜时为甚;肠镜检查则既有疼痛又有不适,尤以检查时为甚。女性比男性疼痛、不适程度高(P<0.01,P<0.05);年龄越小不适程度越高(P<0.01);焦虑程度高的患者疼痛、不适程度高(P<0.01,P<0.05);检查医师操作经验越少的患者疼痛、不适程度越高(P<0.01,P<0.01);肠镜检查比胃镜检查的疼痛、不适程度高(P<0.01,P<0.01)。结论:胃镜和肠镜检查中患者焦虑和疼痛、不适反应及心血管反应存在性别、年龄、文化程度等方面的差别,对于特殊患者或特殊检查应针对性实施麻醉干预。
Objective ： To investigate the prevalence of anxiety and pain/discomfort in patients undergoing GI endoscopy. Methods：IS27 patients referred for gastroscopy or colonoscopy were evaluated and monitored. Anxiety pain/discomfort was rated using self-rating anxiety scale（SAS） and visual analogue scale （ VAS）, respectively Haemodynamic parameters were recorded at 2-min intervals. Patients were grouped by sex, age, education background, previous experience, anxious level, endoscopists＇ experiences and the type of endoscopic procedure. Results： Patients undergoing GI endoscopy showed different levels of anxiety and different intensities of pain/discomfort. The mean SAS score of all patients was 31.50 ＋ 8. 47, higher than that of normal people （29.78 ± 10.07 ）. Females higher anxiety levels than males （ P 〈 0. 0001 ） ,and patients with high school education background had anxiety levels higher than others（P = 0. 026）. Patients undergoing gastroscopy experienced more discomfort, especially during insertion; while patients undergoing colonoscopy experienced pain and discomfort, especially during examination. Pain and discomfort scores were higher in females than in males （ P 〈 0.05, P 〈 0.01 ） , while younger pa- tients had higher discomfort scores （P 〈 0.01 ）. The more anxious patients experienced the more severe pain and discomfort （ P 〈 0.01, P 〈 0.05 ）. The endoscopists＇ experiences significantly influenced patients＇pain and discomfort （P 〈0.01, P 〈0.01）. The intensity of pain/discomfort in patients undergoing colonoscopy was higher than those undergoing gastroscopy （P 〈 0.01, P 〈 0.01 ）. Conclusion ： Patients undergoing GI endoscopy will show mild of anxiety. Gastroscopy or colonoscopy induces different intensities of pain/discomfort and degrees of haemodynamic changes. Anesthetic intervention for GI endoscopy should be individualized according to the type of procedures.
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2006年第2期79-83,共5页
Chinese Journal of Pain Medicine
关键词
消化内镜
焦虑
疼痛
不适
GI Endoscopy
Anxiety
Pain
Discomfort
