摘要目的:评价无痛胃镜检查术患者咽喉反流对镇静相关不良事件的影响。方法:择期行无痛胃镜检查术患者289例，年龄18~75岁，BMI 18.5~28.0 kg/m 2，性别不限，ASA分级Ⅰ~Ⅲ级。分别于胃镜检查术前后，采集声门上咽喉部分泌物标本，采用ELISA法测定胃蛋白酶浓度，剔除术前胃蛋白酶浓度检测呈阳性的患者(浓度≥31.34 pg/ml为阳性)。根据胃镜检查术前后分泌物标本中胃蛋白酶浓度将患者分为咽喉反流组(R组，术后胃蛋白酶浓度检测呈阳性)和非咽喉反流组(N组，术后胃蛋白酶浓度检测呈阴性)。记录术中低氧血症、低血压、心动过缓、呛咳和体动反应的发生情况。术后第1、3和7天电话随访，记录咽痛声嘶、恶心呕吐和咳嗽咳痰发生情况及抗生素使用情况。 结果:与N组比较，R组术中呛咳及低氧血症发生率升高，术后第1天时咽痛声嘶发生率升高，术后第1和3天时咳嗽咳痰发生率升高( P<0.05)。 结论:无痛胃镜检查术患者咽喉反流会增加术中和术后镇静相关不良事件的发生。

abstractsObjective:To evaluate the effect of laryngopharyngeal reflux on sedation-related adverse events in the patients undergoing painless gastroscopy.Methods:Two hundred and eighty-nine American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients of both sexes, aged 18-75 yr, with body mass index 18.5-28.0 kg/m 2, scheduled for elective painless gastrocopy, were selected.Specimens of glottic secretions before and after gastroscopy were collected, and the concentration of human pepsin was measured by enzyme-linked immunosorbent assay.The patients in whom the concentration of pepsin was positive before the examination were excluded (the concentration ≥ 31.34 pg/ml was considered as positive). The patients were divided into laryngopharyngeal reflux group (R group, the concentration of pepsin was positive after gastroscopy) and non-laryngopharyngeal reflux group (N group, the concentration of pepsin was negative after gastroscopy) according to the concentration of pepsin in the secretion samples before and after gastroscopy.The occurrence of hypoxemia, hypotension, bradycardia, bucking and body movement during operation was recorded.The patients were followed up by telephone on the 1st, 3rd and 7th days after operation.The sore throat, hoarseness, nausea and vomiting, cough and expectoration and use of antibiotics were recorded. Results:Compared with group N, the incidence of bucking and hypoxemia was significantly increased, the incidence of sore throat and hoarseness was increased on the 1st day after operation, and the incidence of cough and expectoration was increased on the 1st and 3rd days after gastroscopy in group R ( P<0.05). Conclusion:Laryngopharyngeal reflux can increase the development of intraoperative and postoperative sedation-related adverse events in the patients undergoing painless gastroscopy.