链酶蛋白酶联合二甲基硅油对胃镜检查清晰度的影响
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摘要
目的比较链酶蛋白酶联合二甲基硅油及糜蛋白酶联合二甲基硅油对胃镜检查清晰度影响效果。方法选择2018年1月在山东省千佛山医院内镜中心接受胃镜检查的78例患者,按照随机、双盲原则平均分为2组,A组(链酶蛋白酶组):2万U链酶蛋白酶+1 g碳酸氢钠+二甲基硅油5 g+50 ml温水;B组(糜蛋白酶组):4 000 U糜蛋白酶+1 g碳酸氢钠+二甲基硅油5 g+50 ml温水。对比分析2组术中胃镜视野清晰度。结果 A组的胃窦、胃体、胃底黏膜清晰度及总内镜黏膜清晰度评分均明显优于B组(胃窦:1.7±1.0比1.2±0.5;胃体:2.6±0.8比2.1±0.8;胃底:1.9±0.8比1.5±0.7;总黏膜清晰度:6.2±2.1比4.7±1.6),差异均有统计学意义(P均<0.05)。结论链酶蛋白酶联合二甲基硅油能够明显提高胃镜检查清晰度,且效果明显优于糜蛋白酶联合二甲基硅油。
Objective To assess the efficacies of dimethylpolysiloxane plus pronase and dimethylpolysiloxane plus chymotrypsin for visualization of the mucosa during gastroscopy.Methods A total of 78 patients taken gastroscopy in Department of Endoscopy,Qianfoshan Hospital of Shandong Province were selected in January 2018.All the patients were randomly and double-blindly divided into two groups equally.The patients in group A(pronase group)received the solution of 5 g dimethylpolysiloxane,20 000 U pronase,1 g sodium bicarbonate and 50 ml warm water.The patients in group B(chymotrypsin group)received the solution of 5 g dimethylpolysiloxane,4 000 U chymotrypsin,1 g sodium bicarbonate and 50 ml warm water.The vision clarity of the two groups was contrastively analyzed.Results The antrum visibility,gastric body visibility, fundus visibility and the total visibility of group A were significantly higher than those of group B(antrum:1.7±1.0 vs.1.2±0.5;gastric body:2.6±0.8 vs.2.1±0.8;fundus:1.9±0.8 vs.1.5±0.7;the total visibility:6.2±2.1 vs.4.7±1.6),with statistically significant differences(all P<0.05).Conclusion Combined application of pronase plus dimethylpolysiloxane before gastroscopy significantly improves endoscopic visualization.And the effect is better than chymotrypsin plus dimethylpolysiloxane.
Objective To assess the efficacies of dimethylpolysiloxane plus pronase and dimethylpolysiloxane plus chymotrypsin for visualization of the mucosa during gastroscopy.Methods A total of 78 patients taken gastroscopy in Department of Endoscopy,Qianfoshan Hospital of Shandong Province were selected in January 2018.All the patients were randomly and double-blindly divided into two groups equally.The patients in group A(pronase group)received the solution of 5 g dimethylpolysiloxane,20 000 U pronase,1 g sodium bicarbonate and 50 ml warm water.The patients in group B(chymotrypsin group)received the solution of 5 g dimethylpolysiloxane,4 000 U chymotrypsin,1 g sodium bicarbonate and 50 ml warm water.The vision clarity of the two groups was contrastively analyzed.Results The antrum visibility,gastric body visibility, fundus visibility and the total visibility of group A were significantly higher than those of group B(antrum:1.7±1.0 vs.1.2±0.5;gastric body:2.6±0.8 vs.2.1±0.8;fundus:1.9±0.8 vs.1.5±0.7;the total visibility:6.2±2.1 vs.4.7±1.6),with statistically significant differences(all P<0.05).Conclusion Combined application of pronase plus dimethylpolysiloxane before gastroscopy significantly improves endoscopic visualization.And the effect is better than chymotrypsin plus dimethylpolysiloxane.
引文
1 梁丽明,陈秀梅,张端.链霉蛋白酶对上消化道内镜检查胃内清晰度的效果观察[J].吉林医学,2015,4(36):2083-2084.
2 孙昕,王青.西甲硅油在麻醉胃镜检查中的祛泡作用[J].中华消化内镜杂志,2011,28(10):578-579.
3 Cha JM,Won KY,Chung IK,et al.Effect of pronase premedication on nallow-band imaging endoscopy in patients with precancerous conditions of stomach[J].Dig Dis Sci,2014,59(11):2735-2741.
4 刘晓玲,韩杨,吴桂新,等.二甲硅油散在上消化道内镜诊治中的应用[J].中国内镜杂志,2016,6(22):44-46.
5 倪倩雯,张毅,瞿春莹,等.西甲硅油联合链霉蛋白酶在胃镜检查中的应用[J].胃肠病学和肝病学杂志,2013,22(7):660-663.
6 Petersen BT.Quality assurance for endoscopists[J].Best Pract Res Clin Gastroenterol,2011,25(3):349-360.
7 Kwan V,Devière J.Endoscopy essentials:preparation,sedation,and surveillance[J].Endoscopy,2008,40(1):65-70.
8 Cohen J,Safdi MA,Deal SE,et al.Quality indicators for esophagogastroduodenoscopy[J].Am J Gastroenterol,2006,101(4):886-891.
9 Choi IJ.Gastric preparation for upper endoscopy[J].Clin Endosc,2012,45(2):113-114.
10 王东,方军,厉有名,等.链霉蛋白酶提高胃镜检查图像可见度的前瞻性、多中心、双盲、随机对照临床研究[J].中华消化内镜杂志,2013,30(11):604-607.
11 Chang CC,Chen SH,Lin CP,et al.Premedication with pronase or Naeetylcysteine improves visibility during gastroendoscopy:anendoscopist-blinded,prospective,andomized study[J].World J Gastroenterol,2007,13(3):444-447.
12 武育卫,冯霞,彭贵勇,等.二甲硅油散在上消化道内镜检查中的作用[J].中华消化内镜杂志,2009,26(2):95-96.
13 Tongprasert S,Sobhonslidsuk A,Rattanasiri S.Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation[J].World J Gastroenterol,2009,15(24):3032-3037.
14 Woo JG,Kim TO,Kim HJ,et al.Determination of the optimal time for premedication with pmnase,dimethylpolysiloxane,and sodium bicarbonate for upper gastrointestinal endoscopy[J].J Clin Gastroenterol,2013,47(5):389-392.
15 Lee GJ,Park SJ,Kim SJ,et al.Effectiveness of Premedication with Pronase for Visualization of the Mucosa during Endoscopy:A Randomized,Controlled Trial[J].Clin Endosc,2012,45(2):161-164.
16 Sakai N,Tatsuta M,Iishi H,et al.Pre-medication with pronase reduces artefacts during endoscopic ultrasonography[J].Aliment Pharmacol Ther,2003,18(3):327-332.
17 Capelle LG,Haringsma J,de Vries AC,et al.Narrow band imaging for the detection of gastric intestinal metaplasia and dysplasia during surveillance endoscopy[J].Dig Dis Sci,2010,55:3442-3448.
18 陈新波,丰义宽,初国艳.胃镜术前准备研究进展[J].中华消化内镜杂志.2016,32(2):133-135.
19 李静娴,侯俊,路海云,等.西甲硅油联合糜蛋白酶对提高胃镜检查祛泡效果的影响[J].实用医学杂志,2014,30(20):3342-3344.
20 赵艳春,吴云林,左利平.西甲硅油联合糜蛋白酶溶液作胃镜检查术前准备的临床观察[J].胃肠病学和肝病学杂志,2010,19(11):1019-1021.
2 孙昕,王青.西甲硅油在麻醉胃镜检查中的祛泡作用[J].中华消化内镜杂志,2011,28(10):578-579.
3 Cha JM,Won KY,Chung IK,et al.Effect of pronase premedication on nallow-band imaging endoscopy in patients with precancerous conditions of stomach[J].Dig Dis Sci,2014,59(11):2735-2741.
4 刘晓玲,韩杨,吴桂新,等.二甲硅油散在上消化道内镜诊治中的应用[J].中国内镜杂志,2016,6(22):44-46.
5 倪倩雯,张毅,瞿春莹,等.西甲硅油联合链霉蛋白酶在胃镜检查中的应用[J].胃肠病学和肝病学杂志,2013,22(7):660-663.
6 Petersen BT.Quality assurance for endoscopists[J].Best Pract Res Clin Gastroenterol,2011,25(3):349-360.
7 Kwan V,Devière J.Endoscopy essentials:preparation,sedation,and surveillance[J].Endoscopy,2008,40(1):65-70.
8 Cohen J,Safdi MA,Deal SE,et al.Quality indicators for esophagogastroduodenoscopy[J].Am J Gastroenterol,2006,101(4):886-891.
9 Choi IJ.Gastric preparation for upper endoscopy[J].Clin Endosc,2012,45(2):113-114.
10 王东,方军,厉有名,等.链霉蛋白酶提高胃镜检查图像可见度的前瞻性、多中心、双盲、随机对照临床研究[J].中华消化内镜杂志,2013,30(11):604-607.
11 Chang CC,Chen SH,Lin CP,et al.Premedication with pronase or Naeetylcysteine improves visibility during gastroendoscopy:anendoscopist-blinded,prospective,andomized study[J].World J Gastroenterol,2007,13(3):444-447.
12 武育卫,冯霞,彭贵勇,等.二甲硅油散在上消化道内镜检查中的作用[J].中华消化内镜杂志,2009,26(2):95-96.
13 Tongprasert S,Sobhonslidsuk A,Rattanasiri S.Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation[J].World J Gastroenterol,2009,15(24):3032-3037.
14 Woo JG,Kim TO,Kim HJ,et al.Determination of the optimal time for premedication with pmnase,dimethylpolysiloxane,and sodium bicarbonate for upper gastrointestinal endoscopy[J].J Clin Gastroenterol,2013,47(5):389-392.
15 Lee GJ,Park SJ,Kim SJ,et al.Effectiveness of Premedication with Pronase for Visualization of the Mucosa during Endoscopy:A Randomized,Controlled Trial[J].Clin Endosc,2012,45(2):161-164.
16 Sakai N,Tatsuta M,Iishi H,et al.Pre-medication with pronase reduces artefacts during endoscopic ultrasonography[J].Aliment Pharmacol Ther,2003,18(3):327-332.
17 Capelle LG,Haringsma J,de Vries AC,et al.Narrow band imaging for the detection of gastric intestinal metaplasia and dysplasia during surveillance endoscopy[J].Dig Dis Sci,2010,55:3442-3448.
18 陈新波,丰义宽,初国艳.胃镜术前准备研究进展[J].中华消化内镜杂志.2016,32(2):133-135.
19 李静娴,侯俊,路海云,等.西甲硅油联合糜蛋白酶对提高胃镜检查祛泡效果的影响[J].实用医学杂志,2014,30(20):3342-3344.
20 赵艳春,吴云林,左利平.西甲硅油联合糜蛋白酶溶液作胃镜检查术前准备的临床观察[J].胃肠病学和肝病学杂志,2010,19(11):1019-1021.