Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
Digestion. 2011;84(2):119-25. doi: 10.1159/000323225. Epub 2011 Apr 15.
Capsule endoscopy is limited by the poor image quality of the distal bowel and incomplete small bowel transit. The aim of this study was to establish an optimal medication protocol for capsule endoscopy performed using a real-time viewer.
A total of 80 patients were prospectively recruited. The patients were randomized into two groups: the 'conventional group' (without any preparation) and the 'real-time group' (in which a real-time viewer was attached). At 60 min after swallowing the capsule, if the capsule had reached the small bowel, 500 ml of polyethylene glycol was administered; if the capsule was still located in the stomach, 10 mg of metoclopramide was given intramuscularly, followed by 500 ml of polyethylene glycol solution.
The completion rate was significantly higher in the real-time group as compared with that in the conventional group (72.5 vs. 90.0%). Our protocol yielded a significantly improved image quality of the distal small bowel [image quality score = 1.6 vs. 3.0 (max 4.0)]. The detection rate of lesions in the distal small bowel was higher in the real-time group than in the conventional group.
The present study clearly showed that our protocol yielded an improved completion rate and also improved image quality.
胶囊内镜受到远端肠道图像质量差和小肠不完全通过的限制。本研究旨在建立一种使用实时观察器进行胶囊内镜检查的最佳用药方案。
共前瞻性招募了 80 名患者。患者被随机分为两组：“常规组（无任何准备）”和“实时组（附有实时观察器）”。在吞下胶囊后 60 分钟，如果胶囊已到达小肠，则给予 500 毫升聚乙二醇；如果胶囊仍位于胃中，则给予 10 毫克甲氧氯普胺肌内注射，然后给予 500 毫升聚乙二醇溶液。
实时组的完成率明显高于常规组（72.5%比 90.0%）。我们的方案显著提高了远端小肠的图像质量[图像质量评分=1.6 比 3.0（最高 4.0）]。实时组对远端小肠病变的检出率高于常规组。
本研究清楚地表明，我们的方案提高了完成率，并改善了图像质量。
