Iwamoto Junichi, Mizokami Yuji, Shimokobe Koichi, Ito Masanori, Hirayama Takeshi, Saito Yoshifumi, Honda Akira, Ikegami Tadashi, Matsuzaki Yasushi
Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Turkey.
Hepatogastroenterology. 2010 Nov-Dec;57(104):1356-9.
BACKGROUND/AIMS: Although video capsule endoscopy (CE) is now an established modality for examining the small bowel, in almost 20 - 50 % cases, the capsule does not reach the colon by the end of the recording time. The aim of this study was to investigate whether metoclopramide increases the completion rate of CE examination.
One hundred patients who underwent CE were classified to receive either intravenous treatment with metoclopramide (metoclopramide group: 43 cases) or no treatment at all (control group: 57 cases).
GTT was 18.9 +/- 21.6 min in the metoclopramide group and 37.4 +/- 45.3 min in the control group (p = 0.0053). The capsule reached the cecum in 31 cases (75.6%) of the metoclopramide group and in 38 cases (69.1%) of the control group (p = 0.482). The SBTT and the combined GTT and SBTT were 276.8 +/- 108.9 min, 293.0 +/- 109.4 min in the metoclopramide group and 305.5 +/- 86.9 min, 339.4 +/- 89.2 min in the control group (p = 0.122, p = 0.035).
Although 10 mg of metoclopramide with intravenous drip had shortened the GTT and the combined GTT and SBTT, there was no improvement in the rate of complete small bowel examination and the results of diagnostic yield. Further investigations are necessary to evaluate the concomitant use of other prokinetics or preparations to improve the rate of complete small bowel examination.
背景/目的：尽管视频胶囊内镜（CE）目前是检查小肠的既定方式，但在近20%-50%的病例中，在记录时间结束时胶囊未能到达结肠。本研究的目的是调查甲氧氯普胺是否能提高CE检查的完成率。
100例行CE检查的患者被分为两组，一组接受静脉注射甲氧氯普胺治疗（甲氧氯普胺组：43例），另一组不接受任何治疗（对照组：57例）。
甲氧氯普胺组的胃排空时间（GTT）为18.9±21.6分钟，对照组为37.4±45.3分钟（p = 0.0053）。甲氧氯普胺组31例（75.6%）的胶囊到达盲肠，对照组38例（69.1%）到达盲肠（p = 0.482）。甲氧氯普胺组的小肠通过时间（SBTT）以及GTT与SBTT之和分别为276.8±108.9分钟、293.0±109.4分钟，对照组分别为305.5±86.9分钟、339.4±89.2分钟（p = 0.122，p = 0.035）。
尽管静脉滴注10毫克甲氧氯普胺缩短了GTT以及GTT与SBTT之和，但小肠完全检查率和诊断阳性率并未提高。需要进一步研究评估联合使用其他促动力药或制剂以提高小肠完全检查率。
