目的：探讨无痛胃镜在上消化道疾病诊断和治疗中的安全性和有效性。方法回顾性分析2011年9月~2013年2月在我院内镜室行胃镜检查的2156例上消化道疾病患者的临床资料，普通胃镜组（1293例），采用口服利多卡因胶浆行口腔咽喉部麻醉；无痛胃镜组（863例），采用丙泊酚单一药物静脉麻醉。观察两组患者的心率、血压及血氧饱和度的变化，并对胃镜检查成功率、慢性胃炎患者操作时间、患者满意度、小息肉检出率、检查中不适反应及并发症发生率进行分析。结果无痛胃镜组与普通胃镜组检查前后血压、心率及血氧饱和度异常发生率均无明显统计学差异。无痛胃镜组检查中不适反应及并发症发生率明显低于普通胃镜组（P＜0.01），无痛胃镜组操作时间比普通胃镜组明显缩短（P＜0.05），小息肉检出率和患者满意度均显著高于普通胃镜组（P＜0.05）。结论两种胃镜检查方法均安全可靠，无痛胃镜检查患者痛苦更小、耐受性更好、安全性及有效性更高。%Objective To compare the safety and efficacy of painless gastroscopy and ordinary endoscopy in diagnosis and treatment of upper gastrointestinal disease. Methods 2156 cases of patients with upper gastrointestinal disease, who received gastroscopy in our hospital from September 2011 to February 2013 were retrospectively analyzed. Ordinary gastroscopy group (1293 cases) were treated with oral lidocaine for oral and pharyngeal anesthesia.Painless gastroscope group(863 cases) was treated with single drug propofol intravenous anesthesia. The changes of heart rate, blood pressure and oxygen saturation during gastroscopy were observed. The gastroscopy successful rate, the operating time, the degree of satisfaction of patients, the detection rate of small lesion, the discomfort during gastroscopy and the complication after gastroscopy were analyzed. Results No significant changes were observed in the incidence of abnormalin of blood pressure, heart rate and oxygen saturation before and after gastroscopy in painless gastroscope group and ordinary endoscopy group. The surgery discomfort in painless gastroscope group was significantly lower than ordinary endoscopy group (P<0.01). The small lesion detection rate and patient satisfaction were both significantly higher than ordinary endoscopy group (P<0.05). The operating time in painless gastroscope group was significantly shortened than that in ordinary endoscopy group (P < 0.05). Conclusion Two kinds of endoscopy methods are both safe and reliable.Painless gastroscopy group patients suffer smaller with better tolerability, safety and efficacy. However, the operation should pay attention to the use of local anesthetics to prevent serious complications such as respiratory depression.
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