Niv Y, Niv G
Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petach Tiqwa, Israel.
Scand J Gastroenterol. 2004 Oct;39(10):1005-9. doi: 10.1080/00365520410003209.
Lesions of the small bowel that cannot be detected by other techniques can be indentified by capsule endoscopy. Good preparation before any endoscopic procedure is the most important factor for patient safety, quality of care and cost effectiveness. This should also apply to capsule endoscopy. The aim of this study was to evaluate the quality and efficacy of preparation with oral sodium phosphate for capsule endoscopy.
A retrospective cohort study design was used. The study sample consisted of 32 consecutive patients scheduled for capsule endoscopy in two periods; the first 10 patients were prepared with overnight fasting only, and the next 22 with oral sodium phosphate. An experienced endoscopist and gastroenterology nurse, who were blinded to the method used, graded the quality of preparation.
Small-bowel cleansing was significantly better in patients given sodium phosphate. Five patients (50%) received a poor preparation rating in the first period compared with only 1 (4.5%) of the 22 patients given oral sodium phosphate (P = 0.01). Intraluminal fluid was noted in 9 patients (90%) in the first group after a mean of 53 +/- 60 min, and in 17 patients (77%) in the second group after a mean of 158 +/- 71 min (P < 0.001). The proportion of non-ideal preparation was significantly higher in group 1 than in group 2, significant visualization disturbances being more prevalent in the first period.
Bowel preparation with sodium phosphate before capsule endoscopy offers better visualization than overnight fasting alone and induces fewer disturbances by intraluminal turbid fluid.
其他技术无法检测到的小肠病变可通过胶囊内镜识别。任何内镜检查前的良好准备是保障患者安全、护理质量和成本效益的最重要因素。这一点对胶囊内镜检查也应适用。本研究的目的是评估口服磷酸钠用于胶囊内镜检查准备的质量和效果。
采用回顾性队列研究设计。研究样本包括两个时期连续安排进行胶囊内镜检查的32例患者；前10例患者仅通过夜间禁食进行准备，后22例患者使用口服磷酸钠进行准备。一名经验丰富的内镜医师和胃肠病学护士在对所采用的方法不知情的情况下，对准备质量进行分级。
接受磷酸钠准备的患者小肠清洁效果明显更好。第一时期有5例患者（50%）的准备评级较差，相比之下，在接受口服磷酸钠准备的22例患者中只有1例（4.5%）（P = 0.01）。第一组9例患者（90%）在平均53±60分钟后观察到管腔内有液体，第二组17例患者（77%）在平均158±71分钟后观察到管腔内有液体（P < 0.001）。第一组不理想准备的比例显著高于第二组，第一时期明显的视野干扰更为普遍。
胶囊内镜检查前使用磷酸钠进行肠道准备比单纯夜间禁食能提供更好的视野，并且管腔内浑浊液体引起的干扰更少。
