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聚乙二醇肠道准备对胶囊内镜质量的影响。

Effect of bowel preparation with polyethylene glycol on quality of capsule endoscopy.

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Korea.

出版信息

Dig Dis Sci. 2011 Jun;56(6):1769-75. doi: 10.1007/s10620-010-1500-2. Epub 2010 Dec 16.

Abstract

BACKGROUND AND AIMS

Capsule endoscopy (CE) has the problem that lumen visualization is impaired by bubbles, bile, and debris. The benefits of bowel preparation are still controversial and the best method remains to be determined. The objective of this study was to evaluate the effect of the method of bowel preparation on the quality of visualization and on transit time.

METHODS

The study sample consisted of 68 patients for CE. Patients were randomly allocated to three groups. In group A (n = 23), patients fasted for 12 h before CE. In groups B (n = 20) and C (n = 25), patients received 2 and 4 l of polyethylene glycol (PEG), respectively. Small bowel images were evaluated by use of a cleansing score system. Representative frames were serially selected at 5-min intervals and scored by assessment of two properties (proportion of luminal visibility and extent of obscuration).

RESULTS

The median scores of image quality in groups A, B, and C were 2.26, 2.43, and 2.55 respectively, (P = 0.034). Cecal completion rates, gastric transit time, and small bowel transit time were no different among the three groups. Detection of lesions in groups A, B, and C was 56.5, 65.0, and 68.0%, respectively.

CONCLUSIONS

Bowel preparation with PEG resulted in better image quality than fasting alone. No significant difference was observed between 2 and 4 l. PEG 2 l rather than 4 l may be a useful method of preparation for CE.

摘要

背景与目的

胶囊内镜(CE)存在因气泡、胆汁和碎片导致管腔可视化受损的问题。肠道准备的益处仍存在争议,最佳方法仍有待确定。本研究的目的是评估肠道准备方法对可视化质量和通过时间的影响。

方法

本研究样本包括 68 例接受 CE 的患者。患者被随机分配到三组。在 A 组(n = 23)中,患者在 CE 前禁食 12 小时。在 B 组(n = 20)和 C 组(n = 25)中,患者分别服用 2 和 4 升聚乙二醇(PEG)。使用清洁评分系统评估小肠图像。以 5 分钟的间隔连续选择代表性帧,并通过评估两个属性(管腔可见度比例和遮挡程度)进行评分。

结果

A、B 和 C 组的图像质量中位数评分分别为 2.26、2.43 和 2.55(P = 0.034)。三组的盲肠完成率、胃通过时间和小肠通过时间无差异。A、B 和 C 组的病变检出率分别为 56.5%、65.0%和 68.0%。

结论

PEG 肠道准备比单独禁食可获得更好的图像质量。2 升和 4 升之间没有观察到显著差异。PEG 2 升而不是 4 升可能是 CE 的一种有用的准备方法。

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