西甲硅油预防在使用聚乙二醇灌洗和碘海醇标记进行的CT结肠造影期间结肠气泡形成：一项随机临床试验。

Simethicone to prevent colonic bubbles during CT colonography performed with polyethylene glycol lavage and iohexol tagging: a randomized clinical trial.

作者信息

Hong Gil-Sun, Park Seong Ho, Kim Bohyun, Lee Ju Hee, Kim Jin Cheon, Yu Chang Sik, Baek Seunghee, Lee Jong Seok, Kim Hyun Jin

机构信息

1 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea.

出版信息

AJR Am J Roentgenol. 2015 Apr;204(4):W429-38. doi: 10.2214/AJR.14.13024.

DOI:10.2214/AJR.14.13024

PMID:25794092

Abstract

OBJECTIVE

The purpose of this study was to determine whether the occurrence of numerous colonic bubbles during CT colonography (CTC) performed with polyethylene glycol cleansing and oral iohexol fecal/fluid tagging could be prevented by use of simethicone.

SUBJECTS AND METHODS

Adults with suspected colonic neoplasia who had been randomly assigned to control and simethicone intervention groups underwent CTC after cleansing with 4 L of polyethylene glycol, tagging with 50 mL of 350 mg I/mL oral iohexol, and without (control) or with (intervention) oral administration of 200 mg of simethicone. Colonic segments in the control and intervention groups were evaluated for amount of colonic bubbles during CTC. A 6-point grading system was used in which 0 indicated no bubbles and 5 indicated that more than three fourths of the air-distended mucosa was covered with bubbles. The primary endpoint was a per-patient colonic bubble grade, derived as an average of the segmental grades.

RESULTS

Eighty adults with suspected colonic neoplasia were randomly assigned to the control (40 patients) and simethicone intervention (40 patients) groups. A total of 659 colonic segments in the control group and 689 segments in the intervention group were evaluated for amount of colonic bubbles during CTC. The per-patient colonic bubble score was significantly lower in the simethicone intervention group than in the control group. The mean score was 0.0±0.1 (SD) versus 1.2±0.8 (p<0.001; 95% CI for the mean difference, -1.4 to -1.0). In the intervention group, 673 (97.7%) segments were grade 0, and 16 (2.3%) were grade 1. In contrast, in the control group, 226 (34.3%) segments were grade 0; 173 (26.3%), grade 1; 175 (26.6%), grade 2; 45 (6.8%), grade 3; 23 (3.5%), grade 4; and 17 (2.6%), grade 5.

CONCLUSION

The colonic bubbles associated with fecal/fluid tagging with iohexol can be successfully prevented by adding simethicone to the colonic preparation.

摘要

目的

本研究旨在确定在使用聚乙二醇进行肠道清洁并口服碘海醇进行粪便/液体标记的CT结肠成像（CTC）过程中，使用西甲硅油是否可以预防大量结肠气泡的出现。

受试者与方法

将怀疑患有结肠肿瘤的成年人随机分为对照组和西甲硅油干预组，在使用4L聚乙二醇进行肠道清洁、口服50mL 350mg I/mL碘海醇进行标记后，对照组不口服西甲硅油，干预组口服200mg西甲硅油，然后进行CTC检查。对对照组和干预组的结肠段在CTC检查期间的结肠气泡数量进行评估。采用6分评分系统，0分表示无气泡，5分表示超过四分之三的气体扩张黏膜被气泡覆盖。主要终点是每位患者的结肠气泡分级，通过各段分级的平均值得出。

结果

80名怀疑患有结肠肿瘤的成年人被随机分为对照组（40例患者）和西甲硅油干预组（40例患者）。在CTC检查期间，对对照组的659个结肠段和干预组的689个结肠段的结肠气泡数量进行了评估。西甲硅油干预组每位患者的结肠气泡评分显著低于对照组。平均评分为0.0±0.1（标准差），而对照组为1.2±0.8（p<0.001；平均差异的95%置信区间为-1.4至-1.0）。在干预组中，673个（97.7%）结肠段为0级，16个（2.3%）为1级。相比之下，在对照组中，226个（34.3%）结肠段为0级；173个（26.3%）为1级；175个（26.6%）为2级；45个（6.8%）为3级；23个（3.5%）为4级；17个（2.6%）为5级。