Kondo H, Fukuda H, Ono H, Gotoda T, Saito D, Takahiro K, Shirao K, Yamaguchi H, Yoshida S
Department of Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital, Tokyo, Japan.
Gastrointest Endosc. 2001 Feb;53(2):199-202. doi: 10.1067/mge.2001.110730.
Mucosal iodine staining is known to improve the endoscopic visualization of esophageal squamous dysplasia and cancer. However, it often causes mucosal irritation leading to retrosternal discomfort. The clinical usefulness of sodium thiosulfate solution (STS) for easing symptoms induced by mucosal staining with Lugol's solution was evaluated in this study.
One hundred twenty healthy men over 50 years of age were enrolled in the study. They each underwent esophagogastroscopy including the spraying of Lugol's iodine solution (10 mL) on the mid and distal esophagus and were subsequently randomized into three groups: (I) no treatment (n = 40), (II) spraying of 20 mL of aluminum-magnesium hydroxide gel (Maalox) by means of endoscopic catheter (n = 40), and (III) spraying of 20 mL of 5% sodium thiosulfate solution by means of endoscopic catheter (n = 40). An hour after the endoscopic examination the subjects were asked to complete a questionnaire that addressed adverse symptoms induced by Lugol's iodine staining.
Sodium thiosulfate solution spray substantially reduced adverse symptoms that lasted more than 30 minutes after chromoendoscopy, compared with the no-treatment group. There was no significant difference in the proportion of subjects with symptoms between the Maalox and no-treatment groups. Cost of sodium thiosulfate solution spray per use was $0.15 (15 yen).
Sodium thiosulfate solution is recommended for routine use after Lugol's staining.
黏膜碘染色已知可改善食管鳞状上皮发育异常和癌症的内镜可视化效果。然而，它常引起黏膜刺激，导致胸骨后不适。本研究评估了硫代硫酸钠溶液（STS）缓解卢戈氏溶液黏膜染色所致症状的临床效用。
120名50岁以上的健康男性纳入本研究。他们均接受了食管胃镜检查，包括在食管中段和远端喷洒10 mL卢戈氏碘溶液，随后随机分为三组：（I）不治疗（n = 40），（II）通过内镜导管喷洒20 mL铝镁氢氧化铝凝胶（氢氧化铝镁）（n = 40），以及（III）通过内镜导管喷洒20 mL 5%硫代硫酸钠溶液（n = 40）。内镜检查1小时后，要求受试者完成一份关于卢戈氏碘染色所致不良症状的问卷。
与不治疗组相比，硫代硫酸钠溶液喷洒显著减少了染色内镜检查后持续超过30分钟的不良症状。氢氧化铝镁组和不治疗组有症状受试者的比例无显著差异。每次使用硫代硫酸钠溶液喷洒的成本为0.15美元（15日元）。
建议在卢戈氏染色后常规使用硫代硫酸钠溶液。
