Sakai N, Tatsuta M, Iishi H, Nakaizumi A
Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Aliment Pharmacol Ther. 2003 Aug 1;18(3):327-32. doi: 10.1046/j.1365-2036.2003.01582.x.
Gastric mucus usually induces artefacts during endoscopic ultrasonography.
To investigate the effectiveness of pre-medication with the proteolytic enzyme, pronase, before endoscopic ultrasonography.
Out-patients scheduled for endoscopic ultrasonography were randomly assigned to oral pre-medication with the anti-foam agent, dimethylpolysiloxane, alone (treatment A; n = 29), with dimethylpolysiloxane plus sodium bicarbonate (treatment B; n = 29) or with dimethylpolysiloxane, sodium bicarbonate and pronase (treatment C; n = 29). All drinks were given about 10 min before the start of the procedure. After insertion of the endoscope, endoscopists recorded visibility scores before the procedure, imaging scores at endoscopic ultrasonography and the numbers of high-echo spots in the gastric cavity and on the gastric wall surface after the procedure.
Pre-medication with pronase (treatment C) significantly reduced (both at P < 0.05) the visibility score (score 4, 46%) in comparison with that obtained for pre-medication without pronase (10% for both treatments A and B). Treatment with pronase significantly reduced (both at P < 0.05) the endoscopic ultrasonography score in the gastric cavity (score 4, 34%) in comparison with that found for treatments A (7%) and B (0%). It also significantly reduced (P < 0.05) the endoscopic ultrasonography score on the gastric wall surface (score 4, 14%) in comparison with that observed for treatment A (3%). The numbers of high-echo spots in the gastric cavity and on the gastric wall surface were significantly less (both at P < 0.001) for pre-medication with pronase (treatment C) than for pre-medication with treatments A and B. There were no complications associated with the solutions.
Pre-treatment with pronase reduced the artefacts during endoscopic ultrasonography.
胃黏液在内镜超声检查期间通常会产生伪像。
研究在内镜超声检查前使用蛋白水解酶链霉蛋白酶进行预处理的有效性。
计划进行内镜超声检查的门诊患者被随机分配为单独口服抗泡沫剂二甲硅油进行预处理（治疗A；n = 29）、口服二甲硅油加碳酸氢钠进行预处理（治疗B；n = 29）或口服二甲硅油、碳酸氢钠和链霉蛋白酶进行预处理（治疗C；n = 29）。所有饮品均在检查开始前约10分钟给予。插入内镜后，内镜医师记录检查前的视野评分、内镜超声检查时的成像评分以及检查后胃腔内和胃壁表面的高回声点数量。
与未使用链霉蛋白酶进行预处理相比（治疗A和B均为10%），使用链霉蛋白酶进行预处理（治疗C）显著降低了视野评分（4分，46%）（P均< 0.05）。与治疗A（7%）和B（0%）相比，使用链霉蛋白酶进行治疗显著降低了胃腔内的内镜超声检查评分（4分，34%）（P均< 0.05）。与治疗A（3%）相比，其还显著降低了胃壁表面的内镜超声检查评分（4分，14%）（P < 0.05）。与治疗A和B进行预处理相比，使用链霉蛋白酶进行预处理（治疗C）时胃腔内和胃壁表面的高回声点数量显著更少（P均< 0.001）。这些溶液未出现相关并发症。
链霉蛋白酶预处理可减少内镜超声检查期间的伪像。
