Wei Wei, Ge Zhi-Zheng, Lu Hong, Gao Yun-Jie, Hu Yun-Biao, Xiao Shu-Dong
Department of Gastroenterology, Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Am J Gastroenterol. 2008 Jan;103(1):77-82. doi: 10.1111/j.1572-0241.2007.01633.x. Epub 2007 Nov 15.
To evaluate the effects of the various methods of small bowel preparation on the quality of visualization of the small bowel and the gastrointestinal transit time of capsule endoscopy (CE).
Ninety patients referred for CE were prospectively randomized to three equal groups according to the preparation used: (a) a control group, in which patients were requested to drink 1 L of clear liquids only, 12 h before the examination; (b) a purgative group, in which patients were requested to ingest 1 L of a polyethylene glycol (PEG)/electrolyte solution only, 12 h before the examination; or (c) a purgative combined with simethicone group (P-S group), in which patients were requested to ingest 1 L of PEG, 12 h before the examination, and 300 mg of simethicone, 20 min before the examination. Effects of the different bowel preparations on the gastric transit time (GTT), small bowel transit time (SBTT), examination completion rate, quality of images of the entire small intestine, and cleansing of the proximal small bowel and distal ileum were evaluated.
The number of patients with "adequate" cleansing of the entire small intestine was 17 in the P-S group, 12 in the purgative group, and seven in the control group (P= 0.002). The P-S group had significantly better image quality than the control group (P= 0.001). The P-S group had significantly better image quality for the proximal small bowel (segment A [Seg A]) than the control group (P= 0.0001). Both the P-S group (P= 0.0001) and the purgative group (P= 0.0002) had significantly better image quality for the distal ileum (segment B [Seg B]) than the control group; the P-S group had significantly better image quality than the purgative group as well (P= 0.0121). Gastrointestinal transit time was not different among the three groups, nor was the examination completion rate.
Purgative bowel cleansing combined with simethicone before CE improved the quality of imaging of the entire small bowel as well as the visualization of the mucosa in the proximal and distal small intestine.
评估小肠准备的各种方法对小肠可视化质量及胶囊内镜（CE）胃肠道转运时间的影响。
将90例因CE前来就诊的患者根据所采用的准备方法前瞻性随机分为三组：（a）对照组，患者在检查前12小时仅饮用1升清水；（b）泻药组，患者在检查前12小时仅摄入1升聚乙二醇（PEG）/电解质溶液；或（c）泻药联合西甲硅油组（P-S组），患者在检查前12小时摄入1升PEG，并在检查前20分钟摄入300毫克西甲硅油。评估不同肠道准备方法对胃转运时间（GTT）、小肠转运时间（SBTT）、检查完成率、整个小肠图像质量以及近端小肠和远端回肠清洁情况的影响。
P-S组整个小肠“清洁良好”的患者有17例，泻药组有12例，对照组有7例（P = 0.002）。P-S组的图像质量明显优于对照组（P = 0.001）。P-S组近端小肠（A段[Seg A]）的图像质量明显优于对照组（P = 0.0001）。P-S组（P = 0.0001）和泻药组（P = 0.0002）远端回肠（B段[Seg B]）的图像质量均明显优于对照组；P-S组的图像质量也明显优于泻药组（P = 0.0121）。三组之间的胃肠道转运时间以及检查完成率没有差异。
在CE检查前采用泻药肠道清洁联合西甲硅油可提高整个小肠的成像质量以及近端和远端小肠黏膜的可视化程度。
