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首页> 外文期刊>Surgical Endoscopy >The burden of endoscopic retrograde cholangiopancreatography (ERCP) performed with the patient under conscious sedation
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The burden of endoscopic retrograde cholangiopancreatography (ERCP) performed with the patient under conscious sedation

机译：病人在清醒镇静下进行内镜逆行胰胆管造影（ERCP）的负担

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure that proves burdensome to patients. Nevertheless, very little data are available on patient tolerance of this procedure that may improve practice guidelines and could aid in decreasing the burden of ERCP. This study therefore investigated the burden of ERCP performed with the patient under conscious sedation. Methods: Consecutive patients receiving ERCP under conscious sedation between November 2007 and December 2008 at the University Medical Center Utrecht and Erasmus MC Rotterdam (The Netherlands) were asked to participate in this study. The patients completed questionnaires on demographics, medical history, burden of ERCP (mental health, discomfort, and pain), symptoms and the EuroQol-5D (EQ-5D), including the EQ-VAS (lower EQ-5D scores and higher EQ-VAS scores represent a better quality of life). The paired t-test, the Kruskal-Wallis test, Pearson correlation, and logistic regression were used to evaluate the results. Results: The questionnaire was returned by 149 (54%) of 276 eligible patients, 139 of whom completed the entire questionnaire (54% males; mean age, 60 ± 14 years). Throat ache (p<0.001) was the only symptom higher than baseline value 1 day after the ERCP. On day 1, about onetenth of the patients experienced moderate to severe mental health problems, which were associated with a higher EQ-5D score before ERCP (p = 0.01). Slightly fewer than half of the patients experienced pain and discomfort during and immediately after ERCP. More discomfort was experienced by patients who underwent therapeutic ERCP (p< 0.05) and those with a higher EQ-5D score (p<0.001) or lower VAS (p<0.01). Pain was associated with younger age (p<0.01), higher EQ-5D score (p<0.001), and lower VAS (p<0.01). Conclusion: One-third to one-half of patients experience pain and discomfort during and immediately after ERCP when it is performed with conscious sedation for the patient. Other sedation strategies, such as the use of general anesthesia or propofol, may well reduce the burden of ERCP, particularly for patients with a higher EQ-5D score, younger age, or therapeutic ERCP treatment. However, randomized trials are warranted.
机译：背景：内窥镜逆行胰胆管造影（ERCP）是一种侵入性手术，对患者造成负担。然而，关于患者对该手术耐受性的数据很少，这可能会改善实践指南并有助于减轻ERCP的负担。因此，本研究调查了在有意识的镇静作用下患者进行ERCP的负担。方法：要求2007年11月至2008年12月在乌得勒支大学医学中心和鹿特丹伊拉斯姆斯MC医院接受有意识镇静的ERCP连续患者参加本研究。患者完成了有关人口统计学，病史，ERCP负担（精神健康，不适和疼痛），症状和EuroQol-5D（EQ-5D）的问卷，包括EQ-VAS（EQ-5D得分较低和EQ-较高）。 VAS分数代表生活质量更高）。配对t检验，Kruskal-Wallis检验，Pearson相关性和logistic回归用于评估结果。结果：276位合格患者中的149位（54％）返回了问卷，其中139位完成了整个问卷（男性54％;平均年龄为60±14岁）。 ERCP术后1天，喉痛（p <0.001）是唯一高于基线值的症状。在第1天，约有十分之一的患者经历了中度至重度的精神健康问题，这与ERCP之前EQ-5D评分较高有关（p = 0.01）。仅有不到一半的患者在ERCP期间和之后立即感到疼痛和不适。接受ERCP治疗的患者（p <0.05）和EQ-5D评分较高的患者（p <0.001）或VAS较低的患者（p <0.01）感到更加不适。疼痛与年龄较小（p <0.01），EQ-5D评分较高（p <0.001）和VAS较低（p <0.01）有关。结论：三分之一至二分之一的患者在进行有意识的镇静作用的ERCP期间和之后立即感到疼痛和不适。其他镇静策略，例如使用全身麻醉或异丙酚，可以很好地减轻ERCP的负担，特别是对于EQ-5D评分较高，年龄较小或进行ERCP治疗的患者。但是，必须进行随机试验。

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