| Objective:This study investigated the basic information of patients undergoing gastroscopy and the gastric juice status,and analyzed the related factors affecting the preparation quality of patients' gastric mucosa.In addition,different plans were adopted to intervene in the preparation of gastric mucosa of patients undergoing gastroscopy,so as to explore the influence of different intervention plans on the cleanliness of gastric mucosa of patients,so as to provide certain reference for the improvement of gastric mucosa preparation plans in the future.Methods:A total of 245 patients who underwent painless gastroscopy in the digestive endoscopy center of a third-grade a hospital in jiangxi province from June to August 2019 were selected by convenient sampling method for questionnaire survey,with survey content including age,sex,body mass index(BMI),smoking history,drinking history,symptoms,helicobacter pylori(HP),fasting time,forbidden drinking time,gastric acidity(pH),the characteristics of gastric juice,gastric juice volume,each part of the upper gastrointestinal tract mucosa cleanliness score,to analyze the factors affecting the preparation quality of gastric mucosa.From September to December 2019,180 painless patients with gastroscopy were randomly divided into groups A,B and C using the method of computer generated random Numbers,with 60 patients in each group.Patients in group A(control group)were forbidden to drink ?4h before examination.Patients in group B(clear water group)drank 200 ml clear water for 2h before the examination.Patients in group C(soda group)drank 200 ml of soda water for 2h before the examination.All patients fasted ?8h before the examination,took 80 ml streptomycin protease solution 30 min before the examination,and took a tetracaine hydrochloride endoscopic lubricant(7ml)5-10 min before the examination.Comparative observation was made on the mucosal cleanliness score of each part of the upper digestive tract of the three groups,as well as the positive lesion detection status,biopsy rate and biopsy pathological statistical results.Results:1.Factors affecting the preparation quality of gastric mucosa in patientsA total of 245 patients were investigated and divided into 6 points according to the score of gastric mucosa,?6 points were qualified and > 6 points were unqualified.Among them,83 patients did not meet the requirements of satisfactory preparation of gastric mucosa,and 162 patients meet.In the results of single factor analysis,there were statistically significant differences in BMI,gender,HP testing,gastric fluid characteristics and gastric fluid volume between the qualified and unqualified groups(P < 0.1).All the factors with statistical differences in univariate analysis were included in Logistic regression analysis,and the results showed that BMI?HP testing and gastric fluid characteristics were independent risk factors for inadequate preparation.2.Mucosal cleanliness score,positive lesion detection,biopsy rate and biopsy pathological statistics of the three groupsThe total cleanliness score of gastric mucosa under the microscope was 6.53±1.67;in group A.Group B 5.83±1.45,group C 5.25±1.16,there was a statistical difference between the three groups(P < 0.05).Pairwise comparison was conducted among the three groups,and the results showed that the total cleanliness score of gastric mucosa in group B and C was significantly lower than that in group A,and the difference was statistically significant(P < 0.05).There was no significant difference between group B and group C(P > 0.05).Among the cleanliness scores of various parts of the stomach,there was no significant difference in the cleanliness scores of the bottom of the stomach between groups A,B and C(P > 0.05).The cleanliness scores of the esophagus,stomach and gastric antrum in group C were significantly lower than those in group A,with statistically significant differences(P < 0.05).The esophageal cleanliness score in group B was significantly lower than that in group A(P < 0.05),and there was no significant difference between the two groups in gastric body,gastric antrum and other parts(P > 0.05).There was no significant difference in the mucosal cleanliness score of each part of the stomach between group B and group C(P < 0.05).In the detection of positive lesions,the detected number of positive lesions in the three groups was 29 cases(48.3%)in group A,32 cases(53.3%)in group B,and 33 cases(55.0%)in group c.there was no significant difference between the three groups(P > 0.05).Secondly,there was no significant difference in biopsy number and biopsy rate among the three groups(P >0.05).In the statistical results of biopsy pathology,the detection rate of gastric lesions in group C was higher than that in group A,with a statistically significant difference(P < 0.017).There was no significant difference in the detection rate of gastric lesions between group B and groups A and C(P > 0.017).There was no significant difference in the detection rate of esophageal lesions among the three groups(P >0.05).Conclusion:1.The independent influencing factors of inadequate preparation of gastric mucosa by gastroscopy included BMI,HP and gastric juice.2.2h before gastroscopy,drinking 200 ml clear water or soda water combined with anti-foaming agent and anti-mucinous agent could both improve the cleanliness of gastric mucosa,but the combined soda water was more effective than the combined water solution,and could effectively improve the detection rate of gastric lesions.Therefore,the combination of soda and water has the best effect and is suitable for clinical application. |
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