Bhandari P, Green S, Hamanaka H, Nakajima T, Matsuda T, Saito Y, Oda I, Gotoda T
Portsmouth Hospitals Trust, Portsmouth, UK.
Scand J Gastroenterol. 2010 Mar;45(3):357-61. doi: 10.3109/00365520903483643.
To assess whether endoscopic flushes of the bubble-bursting agent Gascon and the mucolytic agent Pronase are as effective in terms of improving endoscopic mucosal visibility as a pre-endoscopic drink of the same agents.
A total of 112 patients attending a Japanese tertiary referral centre for upper gastrointestinal endoscopy were randomized to receive either the standard Japanese procedure of a pre-endoscopic drink of water containing Gascon and Pronase with endoscopic flushes of 20-ml aliquots of water, or no pre-endoscopic therapy but endoscopic flushes of 20-ml aliquots of water containing Gascon, with or without Pronase as necessary.
Visibility scores were significantly better in the pre-endoscopic drink group than in either of the endoscopic flush groups. The group receiving a pre-endoscopic drink required fewer flushes during the procedure and there was no difference in the endoscopic time between the three groups.
Our results suggest that endoscopic spraying of these bubble-bursting and mucolytic agents is not able to offer equivalent improvements in endoscopic mucosal visibility when compared with the standard Japanese therapy of a pre-endoscopic drink of these agents. The addition of Pronase to the spray solution had no measurable benefit over Gascon alone. We therefore cannot recommend endoscopic spraying of mucous clearing agents over their use as a pre-endoscopic drink.
评估使用泡沫破裂剂加斯康和黏液溶解剂链霉蛋白酶进行内镜冲洗，在改善内镜下黏膜可视性方面是否与内镜检查前饮用相同药物的效果相同。
共有112名前往日本一家三级转诊中心接受上消化道内镜检查的患者被随机分组，一组接受标准的日本流程，即内镜检查前饮用含加斯康和链霉蛋白酶的水，并使用20毫升等分的水进行内镜冲洗；另一组不进行内镜检查前治疗，仅使用含加斯康的20毫升等分的水进行内镜冲洗，必要时添加或不添加链霉蛋白酶。
内镜检查前饮水组的可视性评分显著高于任何一个内镜冲洗组。接受内镜检查前饮水的组在检查过程中需要的冲洗次数更少，三组之间的内镜检查时间没有差异。
我们的结果表明，与日本标准的内镜检查前饮用这些药物的治疗方法相比，内镜喷洒这些泡沫破裂剂和黏液溶解剂并不能在改善内镜下黏膜可视性方面提供同等的效果。在喷雾溶液中添加链霉蛋白酶与单独使用加斯康相比没有可测量的益处。因此，我们不推荐内镜喷洒黏液清除剂，而建议使用内镜检查前饮用的方式。
