禁食12小时和聚乙二醇方案对显性小肠出血患者胶囊内镜检查肠道准备效果比较  

Overnight fasting only or polyethylene glycol preparation for capsule endoscopy for detection of the source of overt suspected small bowel bleeding:a retrospective study

作　　者：戴靖萍 丁卓宇 潘朝敏 杨丽[1] 魏依依 王馨珂 DAI Jing-ping;DING Zhuo-yu;PAN Chao-min;YANG Li;WEI Yi-yi;WANG Xin-ke(Department of Gastroenterology,Nanfang Hospital,Southern Medical University,No.1838,Guangzhou Avenue North,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院消化内科,510515

出　　处：《现代消化及介入诊疗》2023年第12期1475-1479,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学基金(82203555);广东省基础与应用基础研究基金(2019A5110078)。

摘　　要：目的 探讨禁食12小时与聚乙二醇方案对胶囊内镜肠道准备的有效性。方法 采用回顾性、单中心研究,纳入102例为检测可疑的活动性显性小肠出血来源行胶囊内镜检查的患者。A组63例患者采用2L聚乙二醇方案;B组39例患者在检查前禁食12小时。主要终点是病变检出率和诊断率,次要终点是临床结局、胶囊内镜完成率、运转时间和图像质量。结果A组发现阳性病变38例(60.3%),B组18例(46.2%)。两组患者的诊断率差异无统计学意义(47.6%vs.51.3%;P=0.719)。A组胶囊内镜图像质量明显优于B组(57.2%vs.38.5%;P=0.0012)。A组平均小肠运转时间短于B组(400 min vs.519 min;P=0.01)。两组患者进一步治疗方法及预后差异无统计学意义(均P>0.05)。结论 与禁食12小时相比,2L PEG方案虽然提高了胶囊内镜图像质量,但并没有提高诊断率和改善临床结局。Objective To assess the effectiveness of the purgative regimen and the 12-hour fasting only method before undergoing small bowel capsule endoscopy(SBCE).Methods This was a retrospective study of 102 patients who underwent SBCE to detect the source of active or sub-acute overt suspected small bowel bleeding.A total of 63 Patients in Group A consumed 2L of PEG(polyethylene glycol) before SBCE;whereas 39 patients in Group B performed 12-hour overnight fast before the procedure.The primary endpoint was lesion findings and diagnostic yield,and the secondary endpoints were clinical outcomes,capsule endoscopy completion rate,transit time and the small bowel visualization quality(VQ).Results The positive finding was ascertained in 38 patients in Group A(60.3%),and 18 in Group B(46.2%).There was no significant difference in diagnosis yield in 2 groups(47.6% vs.51.3%;P=0.719).The percentage of excellent or good small bowel VQ in Group A was significantly more than in Group B(57.2% vs.38.5%,P=0.0012).The median small-bowel transit time for Group A was statistically significant shorter than Group B(400 min vs.519 min;P=0.01).No evidence of differences was detected between the two groups in further treatment methods and prognosis(P=0.209).Conclusion 2L PEG-based bowel preparation before SBCE did not result in improvement of diagnostic yield or clinical outcomes,although the small bowel visualization quality is enhanced.

关 键 词：胶囊内镜 小肠出血 肠道准备 聚乙二醇 

分 类 号：R574[医药卫生—消化系统]