N-乙酰半胱氨酸对食管碘染色后不适症状的缓解作用  

The effect of N-acetylcysteine in relieving discomfort symptoms after esophageal iodine staining

作　　者：李辰璐 付旋 刘浩[1] 徐艳秋[1] 唐明 赵敏[1] 田书信[1] Li Chenlu;Fu Xuan;Liu Hao;Xu Yanqiu;Tang Ming;Zhao Min;Tian Shuxin(Department of Gastroenterology,the First Affiliated Hospital,Shihezi University,Shihezi 832008,China;School of Medicine,Shihezi University,Shihezi 832008,China)

机构地区：[1]石河子大学第一附属医院消化内科,石河子832008 [2]石河子大学医学院,石河子832008

出　　处：《中华消化杂志》2024年第8期508-513,共6页Chinese Journal of Digestion

基　　金：兵团科技计划项目(2023AB056);中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2020-PT330-003);石河子大学创新发展专项项目(CXFZ202210)。

摘　　要：目的评价N-乙酰半胱氨酸(NAC)对食管复方碘溶液染色后不适症状的缓解作用。方法纳入2023年4月1日至9月30日于石河子大学第一附属医院行内镜检查的204例受检者。所有受检者在内镜检查完成后均予10 mL 1.5%复方碘溶液染色,采用随机数字表法将204例受检者分为氯化钠组(103例)和NAC组(101例),分别给予20 mL 0.9%氯化钠溶液、10%NAC中和碘剂。分析两组受检者的主要结局指标,包括喷洒中和溶液15、30 min后胸骨后烧灼感和咽部不适发生率,并用视觉模拟评分法(VAS)评估不适程度。统计学方法采用Fisher确切概率法和非参数秩和检验。结果氯化钠组喷洒中和溶液15、30 min后的胸骨后烧灼感、咽部不适发生率均高于NAC组[15 min:17.5%(18/103)比2.0%(2/101)、10.7%(11/103)比1.0%(1/101),30 min:11.7%(12/103)比1.0%(1/101)、5.8%(6/103)比0(0/101)],差异均有统计学意义(Fisher确切概率法,P<0.001、=0.005、=0.003、=0.029)。氯化钠组与NAC组喷洒中和溶液15 min后的VAS分值比较[3.00(3.00,4.25)分比4.00(3.00,5.25)分],差异无统计学意义(P>0.05)。氯化钠组喷洒中和溶液30 min后的VAS分值高于NAC组[4.00(3.75,5.00)分比1.50(1.00,1.50)分],差异有统计学意义(Z=-2.37,P=0.007)。结论NAC可有效缓解食管复方碘溶液染色引起的不适症状。Objective To evaluate the effect of N-acetylcysteine(NAC)in relieving discomfort symptoms after esophageal Lugol′s iodine staining.Methods From April 1 to September 30,2023,a total of 204 subjects who received endoscopy at the First Affiliated Hospital of Shihezi University were enrolled.All the subjects were stained with 10 mL 1.5%compound iodine solution after endoscopy.According to random number table method,the 204 subjects were randomly divided into two groups which received 20 mL 0.9%sodium chloride solution(sodium chloride group,103 cases)and 10%NAC(NAC group,101 cases)to neutralize the iodine,respectively.The primary outcome indicators of the subjects of the two groups were analyzed,including the incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution,and the degree of discomfort was evaluated by visual analogue scale(VAS).Fisher′s exact probability method and non-parametric test were used for statistical analysis.Results The incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution in the sodium chloride group were higher than those in the NAC group(15 min:17.5%(18/103)vs.2.0%(2/101),10.7%(11/103)vs.1.0%(1/101);30 min:11.7%(12/103)vs.1.0%(1/101),and 5.8%(6/103)vs.0(0/101)),and the differences were statistically significant(Fisher′s exact probability method,P<0.001,=0.005,=0.003,and=0.029).There was no significant difference in the VAS score 15 min after spraying neutralization solution between the sodium chloride group and the NAC group(3.00(3.00,4.25)vs.4.00(3.00,5.25),P>0.05).At 30 min after spraying the neutralization solution,the VAS score of the sodium chloride group was higher than that of the NAC group(4.00(3.75,5.00)vs.1.50(1.00,1.50)),and the difference was statistically significant(Z=-2.37,P=0.007).Conclusion NAC can effectively relieve the discomfort caused by esophageal iodine staining.

关 键 词：早期食管癌 复方碘溶液 食管癌筛查 N-乙酰半胱氨酸 

分 类 号：R735.1[医药卫生—肿瘤]