Abstract: Background　It is clinically found that patients who talk to each other and make phone calls before gastroscopy have poor gastric cleanliness，which easily affects the diagnosis of the disease.At present，the preparation work before gastroscopy in China is mostly on the selection and requirements of medication，and patients are not required to control their own speech and keep quiet.Objective　To investigate the effect of talking control before gastroscopy on the clarity of endoscopic visual field.Methods　A total of 202 patients who met the research criteria for gastroscopy were selected in Ningnan Hospital of People's Hospital of Ningxia Hui Autonomous Region from November 2017 to January 2018.The patients were divided into the observation group （104 cases） and the control group （98 cases） by the random number table method.Before the examination，patients in both groups were given oral dimethicone powder and buccal tetracaine mortar.The patients in the observation group were advised to keep as quiet as possible and not to talk to each other during the waiting period； the patients in the control group were advised to keep quiet without special requirements for speech.The visual field clarity scores，diagnosis results，detection rates of micro lesions，heart rates before and after gastroscopy，and examination time were compared between the two groups.Results　The clarity scores of gastric fundus，upper gastric body，lower gastric body and gastric antrum and the total clarity score of endoscopic visual field in the observation group were lower than those in the control group （P<0.05）.The detection rate of micro lesions in the observation group was 25.0%（26/104），which was higher than that in the control group〔13.2%（13/98）〕 （χ2=4.460，P=0.035）.There was no significant difference in heart rates between the two groups before and after gastroscopy（P>0.05）.The examination time in observation group was shorter than that in control group〔（7.1±1.0）min vs.（7.8±1.2）min〕（t=-3.966，P<0.05）.Conclusion　Asking patients to control their own talking before gastroscopy can effectively improve the clarity of visual field in the stomach，shorten the examination time，and improve the detection rate of micro lesions.

Key words: Stomach diseases, Gastroscopy, Talking control, Visual fields, Outcome assessment

摘要： 背景　临床发现，胃镜检查前相互攀谈、打电话的患者胃内清洁度差，易影响疾病的诊断。目前我国胃镜检查前的准备工作多是针对用药的选择和要求，并未要求患者对自己的言语进行管控并要求其保持安静。目的　探究胃镜检查前患者言语管控对其胃镜视野清晰度的影响。方法　选取2017年11月—2018年1月在宁夏回族自治区人民医院宁南医院行胃镜检查的符合研究标准的患者202例。依据随机数字表法将患者分为观察组104例和对照组98例。两组患者检查前均口服二甲硅油散、含服丁卡因胶浆。叮嘱观察组患者在候诊期间尽量保持安静，不要攀谈讲话；叮嘱对照组患者保持安静，对言语与否未做特殊要求。比较两组患者胃镜视野清晰度评分、胃镜诊断结果、微小病变检出率、胃镜检查前后心率及胃镜检查时间。结果　观察组患者胃底、胃体上部、胃体下部、胃窦胃镜视野清晰度分级评分及胃镜视野清晰度分级总分均低于对照组（P<0.05）。观察组患者微小病变检出率为25.0%（26/104），高于对照组的13.2%（13/98）（χ2=4.460，P=0.035）。两组患者胃镜检查前后心率比较，差异均无统计学意义（P>0.05）；观察组患者胃镜检查时间短于对照组〔（7.1±1.0）min与（7.8±1.2）min〕（t=-3.966，P<0.05）。结论　在胃镜检查前让患者对自己言语进行管控可有效提高胃内视野的清晰度、缩短检查时间，提高胃微小病变的检出率。

关键词: 胃疾病, 胃镜检查, 言语管控, 视野, 结果评价