Villa Federica, Signorelli Clementina, Rondonotti Emanuele, de Franchis Roberto
Gastroenterology and Gastrointestinal Endoscopy Unit, Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena Foundation, Via Pace 9, Milan 20122, Italy.
Gastrointest Endosc Clin N Am. 2006 Apr;16(2):211-20. doi: 10.1016/j.giec.2006.01.020.
The evaluation of the importance of bowel preparations, prokinetics and postural tricks for bowel cleanliness, completeness of evaluation, and ultimately for the diagnostic yield of VCE is hampered by several factors. First, most studies are published in abstract form. Second, the methodological quality of the studies is rather low, because randomized comparisons are only a small minority. Third,there is no accepted and validated scale to evaluate bowel cleanliness. For all of these reasons, comparisons between studies are very difficult, and drawing general conclusions is almost impossible. As a consequence, at the Fifth International Conference on Capsule Endoscopy [9], only a limited measure of consensus could be reached on the fact that preparations/prokinetics probably improve the quality of small bowel cleanliness. It also was agreed that it is possible that preps/prokinetics improve GTT, SBTT and completeness of examination, and that keeping the patients recumbent in the right lateral position may shorten the GTT. It was noted, however, that the best type of preparation, and dose and time of administration remain to be determined. Additionally, data on prokinetics and postural tricks are insufficient to reach a firm conclusion. Unanswered questions concern the effect of medications on the diagnostic yield of VCE, whether prokinetics increase the miss rate, whether preparations/prokinetics cause adverse effects and the influence of medications on patient acceptance.
肠道准备、促动力药和体位技巧对肠道清洁度、评估完整性以及最终对小肠胶囊内镜检查（VCE）诊断率的重要性评估受到多种因素的阻碍。首先，大多数研究以摘要形式发表。其次，研究的方法学质量相当低，因为随机对照研究仅占少数。第三，尚无公认且经过验证的评估肠道清洁度的量表。由于所有这些原因，研究之间的比较非常困难，几乎不可能得出一般性结论。因此，在第五届国际胶囊内镜会议上，对于准备工作/促动力药可能会提高小肠清洁质量这一事实，仅达成了有限的共识。与会者还一致认为，准备工作/促动力药有可能改善胃排空时间（GTT）、小肠通过时间（SBTT）和检查完整性，并且让患者保持右侧卧位可能会缩短GTT。然而，有人指出，最佳的准备类型、给药剂量和时间仍有待确定。此外，关于促动力药和体位技巧的数据不足以得出确凿结论。未解决的问题包括药物对VCE诊断率的影响、促动力药是否会增加漏诊率、准备工作/促动力药是否会引起不良反应以及药物对患者接受度的影响。
