胃镜和肠镜检查是胃癌和结肠癌筛查的金标准，近年来国内胃肠镜的实施数量大幅增加，麻醉胃肠镜比例上升迅速，但目前尚无大样本研究对麻醉和非麻醉胃肠镜的检查质量和安全性进行比较。本研究旨在通过对国内大规模调研数据分析麻醉和非麻醉胃肠镜检查的现状，并比较两者有效性和安全性的区别。本研究主要对“麻醉对胃肠镜检查患者依从性影响的多中心调研” 的数据进行分析。本研究共纳入3090例胃镜和1202例肠镜检查的数据，其中麻醉胃镜患者1552例，非麻醉胃镜患者1538例，麻醉肠镜患者608例，非麻醉肠镜患者594例。在分析患者基线情况基础上，对麻醉胃镜和非麻醉胃镜，麻醉肠镜和非麻醉肠镜患者检查的有效性和安全性分别进行统计分析发现：麻醉胃镜组的痛苦程度显著低于非麻醉胃镜组（P＜0.001），患者和内镜医生对操作过程的满意度显著高于非麻醉胃镜组（P＜0.001），到达十二指肠的比例相当（P=0.587），检查总时间与非麻醉组相当（P=0.186）；麻醉胃镜组并发症的整体发生率显著低于非麻醉胃镜组（P＜0.001），但喉痉挛和呼吸道梗阻的比例显著高于非麻醉胃镜组（P＜0.01），除检查开始后20分钟外，检查过程中及检查结束后麻醉胃镜组患者心率和血压始终显著低于非麻醉胃镜组（P＜0.001），两组氧饱和度变化幅度均不大，但除检查开始后15分钟外其余时间点上麻醉胃镜组显著高于非麻醉胃镜组（P＜0.05）；麻醉肠镜组患者的痛苦程度显著低于非麻醉肠镜组（P＜0.001），患者和内镜医生对操作过程的满意度高于非麻醉肠镜组（P＜0.001），到达回盲部的比例相当（P=0.381），检查总时间显著短于非麻醉肠镜组（P＜0.001），退镜时间也显著短于非麻醉肠镜组（P=0.001）；麻醉肠镜组并发症的整体发生率显著低于非麻醉肠镜组（P＜0.001），除检查开始后30、35、40分钟外，检查过程中及检查结束后麻醉肠镜组患者心率始终显著低于非麻醉肠镜组（P＜0.001），除开始后30、35、40分钟外，检查过程中及检查结束后麻醉肠镜组患者血压始终显著低于非麻醉肠镜组（P＜0.05），两组氧饱和度变化幅度均不大，但在检查开始时至开始后30分钟以及检查结束时无痛肠镜组的氧饱和度显著高于非麻醉组（P＜0.05）。本研究基于真实临床数据资料，对当前国内的麻醉和非麻醉胃、肠镜检查现状进行了分析和对比，对二者的检查效果和安全性进行比较，从检查有效性和安全性的客观角度、患者和医生的舒适度、满意度的主观感受角度为今后实施更加有效的胃肠道癌症筛选策略提供参考。

Gastroscopy and colonoscopy are the gold standards for the screening of gastric cancer and colon cancer. The total number of gastrointestinal endoscopy procedures in China has increased significantly over the past few years, and the proportion of the sedated gastroscopy procedures has increased rapidly. However, there is no study to compare the difference of the quality and safety between sedated and unsedated gastrointestinal endoscopy procedures with a large sample. The purpose of this study was to give a description of the current status of sedated and unsedated gastrointestinal endoscopy in China and to compare the difference of the efficacy and safety between them by the analysis of the data of previous investigation with a large sample.This study is a retrospective analysis to the data of the original research of the multicenter compliance survey in gastrointestinal endoscopy patients. A total of 3090 patients who underwent gastroscopy and 1202 patients who underwent colonoscopy were included in this study, among which 1552 patients were given sedated gastroscopy, 1538 patients were given unsedated gastroscopy, 608 patients were given sedated colonoscopy, and 594 patients were given unsedated colonoscopy. Based on the analysis of the baseline conditions, statistical analysis was conducted on the efficacy and safety of sedated and unsedated gastroscopy and colonoscopy procedures. It was found the mean VAS pain score of patients in the sedated gastroscopy group was significantly lower than of patients in unsedated group （P＜0.001）. The satisfaction for the operation process of patients and doctors in the sedation group was significantly higher （P＜0.001）. The proportion of patients in whose procedure the duodenum was reached in the sedated gastroscopy group was comparative to that in the unsedated group （P=0.587）, but the mean duration of gastroscopy is comparable （P=0.186）. The incidence of complications in the sedated gastroscopy group was significantly lower than that in the unsedated group （P＜0.001）, but the incidences of laryngospasm and airway obstruction were significantly higher in the sedated group （P＜0.01）. The mean heart rate and blood pressure in the sedated gastroscopy group were usually significantly lower than that in the unsedated group from the beginning of the procedure until the procedure had been completed except the time point of 20 minutes after the beginning of the procedure （P＜0.001）. The absolute variation of oxygen saturation was small in both groups, but the mean oxygen saturation was significantly higher in the sedated gastroscopy group during the whole procedure except 15 minutes after the beginning（P＜0.05）. The mean VAS pain score of patients in the sedated colonoscopy group was significantly lower than of patients in unsedated group （P＜0.001）. The satisfaction for the procedure of patients and doctors in the sedation group was significantly higher （P＜0.001）. The cecal intubation rate in the sedated colonoscopy group was comparative to that in the unsedated group （P=0.381）, but the mean duration of colonoscopy in the sedated group was significantly shorter （P＜0.001）, so as the withdrawal time （P＜0.001）. The incidence of complications in the sedated colonoscopy group was significantly lower than that in the unsedated group （P＜0.001）. The mean heart rate in the sedated colonoscopy group was usually significantly lower group than that in the unsedated group from the beginning of the procedure until the procedure had been completed except the time point of 30 minutes after the beginning of the procedure （P＜0.001）. The mean systolic blood pressure in the sedated colonoscopy group was usually significantly lower group than that in the unsedated group from the beginning of the procedure until the procedure had been completed except the time point of 30 minutes after the beginning of the procedure （P＜0.05）. The absolute variation of oxygen saturation was small in both groups, but the mean oxygen saturation was significantly higher in the sedated colonoscopy group from the beginning of the procedure until 30 minutes after the beginning and at the end of the procedure （P ＜0.05） than the unsedated group.Based on the real world data, we conducted the analysis of the current status of the sedated and the unsedated gastroscopy procedures in China and the comparison of efficacy and safety was conducted between them. We try to provide a reference for a more effective screening strategy of gastrointestinal cancer with gastrointestinal endoscopy from both the objective perspective of the efficacy and safety and the subjective perception of the patients and doctors during sedated and unsedated gastroscopy and colonoscopy procedures.