摘要
目的 :纤维胃镜检查是诊断小儿上消化道疾病先进的介入性的方法 ,探讨检查过程中是否会对小儿产生不良影响及安全性问题。观察对象 :2 74例 3.5～ 13岁小儿胃镜操作过程中的反应 ,并根据小儿哭闹、面色、配合及一般情况判断其耐受程度。良好 :表现为安静、自觉配合 ;一般 :表现为有哭闹 ,但劝之能配合 ;差 :表现为哭闹 ,劝之不止 ,不配合。并对其中 39例做了动态心电图监测。结果 :全部小儿顺利接受胃镜检查 ,耐受者良好者 176例(6 3.5 0 % ) ,无 1例意外反应。其中体型肥胖能配合者 2 3例 ,耐受程度良好者 12例 (5 2 .17% ) ,一般者 8例 (34 .78% ) ,差者 3例 (13.0 4% ) ;体型中等 15 5例 ,耐受良好者 114例 (73.5 5 % ) ,一般者 2 9例 (18.71% ) ,差者 12例 (7.74% ) ;体型消瘦 96例 ,耐受良好者 5 2例 (5 4.17% ) ,一般者 2 7例 (2 8.13% ) ,耐受差者 17例 (17.71% )。 39例心电监测显示在胃镜管行至各部位时的心率明显快于检查前 (P <0 .0 5 ) ,检查前平均心率为 97.2次 /min ,检查中为 12 9.33次 /min ,检查中较检查前心率平均增加 32 .13次 /min ,而在检查中上消化道各部位的心率变化差异无显著性 (P >0 .0 5 )。退出胃镜后心率完全恢复到术前正常范围的时间最短 2min ,最长 5min ,无其它严重心?
Object:Currently,gastroscopy is the most advanced method to diagnose the diseases of children's upper digestive tract.Because it is invasive,both patients and doctors are concerning about whether gastroscopy will have ill effect on children,as well as safety problem during the examination Observation object:Continually observed the reactions of 274 cases varying from 3.5 13 years old in the process of gastroscopy.According to children's crying,complexion,cooperation,and general condition,we can learn their different level of toleration.Excellent:the baby performs quiet and can self consciously cooperate with doctors and nurses.Average:the baby cries but cooperate with doctors after persuasion.Undirsiable:the baby always cries even under nurses' persuasion, can not cooperate with doctors.We also monitored 39 children's dynamic ECG out of the 274 cases. Result:All could accept gastroscopy favorably,176 babies(63.5%) had good tolerance,with no accident.The obese account for 23,among which,12 had good tolerance (52.17%),8 had average tolerance(34.78) and 3 had ill tolerance (13.04).In the group of mesosoma,all together 155 cases,the number of good tolerance was 114 (73.55%),the counterpart of average tolerance were and ill tolerance were 12(7.74%) respectively.There were 96 marasmic children,in which group,good tolerance 52(54.17%),average tolerance 27( 28.13%) ,ill tolerance 17(17.71%).We can draw a conclusion by monitoring 39 children's ECG changes that their heart rates were obviously faster than those before examination ( P<0.05 ),when gastroscopes were drawn into varies parts of these children.Before examination,their average heart rate was 97.2/min,in the examination was 129.33/min.Compared to the heart rate before examination,It increased 32.13/min averagely,but there was no significant differences among heart rates,when gastroscope was in the various parts of upper digestive tract ( P<0.05 ).Heart rate completely came back to normal range,when gastroscope withdrawn.Recovering time was from 2 min to 5 min,with no serious arrhythmia.Outcome:Children's gastroscopy is safe if proper psychological nursing is given before and in the examination.It is beneficial to promote the success of gastroscopy. Author's address Ruijin hospital affiliated to S.S.M.U,Shanghai,200025
出处
《中华护理杂志》
CSCD
北大核心
2000年第4期200-202,共3页
Chinese Journal of Nursing
