胃准备与磁控胶囊胃镜检查间隔时间的完全随机对照研究  

Time interval between gastric preparation and magnetic-controlled capsule endoscopy:a randomized controlled trial

作　　者：吴嘉钏 陈睿妍 陈晓东 叶丽芳[1] 杨小乔[1] 梁彪[1] 李海珠[1] 叶莉莉 Wu Jiachuan;Chen Ruiyan;Chen Xiaodong;Ye Lifang;Yang Xiaoqiao;Liang Biao;Li Haizhu;Ye Lili(Digestive Endoscopy Center of Guangdong Second Provincial General Hospital,Guangzhou 510317,China)

机构地区：[1]广东省第二人民医院消化内镜中心,广州510317

出　　处：《新医学》2020年第4期304-309,共6页Journal of New Medicine

摘　　要：目的探讨磁控胶囊胃镜检查前最适宜胃准备时机.方法进行磁控胶囊胃镜检查患者81例,受检前均禁食8 h以上,术前口服二甲基硅油散+链霉蛋白酶+碳酸氢钠.患者随机分成3组:A组口服胃准备药物后30 min内进行检查;B组口服胃准备药物后30~60 min内进行检查;C组口服胃准备药物后60 min后进行检查.分析比较3组患者胃部清洁度及观察视野评分、安全性、耐受性、追加水量与阳性病变检出率.同时分析胃部清洁度、观察视野的相关因素.结果A、B、C组的胃部清洁度及视野评分分别为20.44±2.61与16.33±2.01、20.96±1.68与16.41±1.50、20.56±2.90与16.07±1.96,3组的胃部清洁度及观察视野评分比较差异均无统计学意义(P均>0.05).A组阳性病变检出率为16例(59.3%),B组18例(66.7%),C组15例(55.6%),3组比较差异亦无统计学意义(P>0.05).3组追加饮水量分别为(107.41±70.31)ml、(46.30±39.04)ml、(79.63±65.43)ml,B组追加饮水量比A组、C组少(P均<0.001).胃部清洁度及观察视野评分总分均与幽门螺杆菌感染呈负相关,感染程度越轻,评分越高(rs=-0.326,P=0.003及rs=-0.235,P=0.035).结论磁控胶囊胃镜使用二甲基硅油散+链霉蛋白酶+碳酸氢钠进行胃准备后分别在30 min内、30~60 min,60 min以上行磁控胶囊内镜操作,三者胃腔内清洁度与显示度、阳性病变检出率比较差异均无统计学意义,但30~60 min组检查过程中补充水量最少,提示该时间可能为最适合的间隔时间.Objective To investigate the optimal time interval between gastric preparation and magnetic-controlled capsule endoscopy(MCE)by comparing the effect of three time intervals on the image quality of stomach,tolerance,safety and detection rate of positive lesions through a randomized controlled trial.Methods Prior to MCE,eighty-one patients were fasting for at least 8 h and administrated with dimethicone,pronase and sodium bicarbonate.All patients were randomly assigned into three groups.In group A,MCE was performed within a time interval of 30 min after gastric preparation,a time interval of 30-60 min in group B and a time interval of 60 min in group C,respectively.The gastric cleanliness and visualization scores,safety,tolerance,volume of supplement water and detection rate of positive lesions were statistically compared among three groups.A multi-variate analysis was conducted on gastric cleanliness and visualization scores.Results The mean cleanliness scores were 20.44±2.61(group A),20.96±1.68(group B)and 20.56±2.90(group C),respectively.The visualization scores were 16.33±2.01(group A),16.41±1.50(group B),and 16.07±1.96(group C),respectively.There was no statistical significance among three groups(all P>0.05).MCE could detect positive lesions in 16(59.3%),18(66.7%)and 15(55.6%)patients in groups A,B and C,respectively,with no statistical significance among three groups(P>0.05).The volume of supplement water during MCE was(107.41±70.31)ml,(46.30±39.04)ml and(79.63±65.43)ml in groups A,B and C,respectively.The volume in group B was significantly less than those in the other two groups(both P<0.0013).The gastric cleanliness and visualization scores were negatively correlated with the infection of Helicobacter pylori(rs=-0.326,P=0.003 and rs=-0.235,P=0.035).Conclusions The gastric cleanliness,visualization scores and diagnostic rate of positive lesions do not significantly differ among patients who receive MCE within 30 min,30-60 min and 60 min after administration with dimethicone,pronase and sodium bicar

关 键 词：胶囊胃镜 清洁度 观察视野 间隔时间 

分 类 号：R573[医药卫生—消化系统]