Papamichael Konstantinos, Karatzas Pantelis, Theodoropoulos Ioannis, Kyriakos Nikos, Archavlis Emmanuel, Mantzaris Gerasimos J
Department of Gastroenterology, Evaggelismos Hospital, Athens, Greece.
Ann Gastroenterol. 2015 Oct-Dec;28(4):464-8.
Currently, there is no standardized protocol for bowel preparation before small bowel capsule endoscopy (SBCE). This study aimed to investigate the effect of simethicone combined with polyethylene glycol (PEG) on the visualization quality (VQ) of the SBCE in patients with or without known or suspected Crohn's disease (CD).
This observational, prospective, single-center study included consecutive patients undergoing a SBCE between 2007 and 2008. Patients received either a standard bowel cleansing preparation of 2 L PEG and 80 mg simethicone orally 12 and 1 h before SBCE respectively (Group A) or only PEG (Group B). VQ, based on scores for luminal bubbles in frames taken from the small intestine, examination completeness, SBCE diagnostic yield, gastric and small bowel transit times were recorded.
Of the 115 patients finally included (Group A, n=56 and Group B, n=59) the cecum was visualized in 103 (89.6%). Simethicone overall improved the VQ in the proximal [OR: 2.43 (95%CI: 1.08-5.45), P=0.032] but not in the distal bowel segment (P=0.064). Nevertheless, this effect was not observed in patients undergoing SBCE for either known or suspected CD.
Simethicone as an adjunct to PEG for bowel preparation in patients undergoing SBCE significantly improved the VQ in non-CD patients.
目前，小肠胶囊内镜检查（SBCE）前尚无标准化的肠道准备方案。本研究旨在探讨西甲硅油联合聚乙二醇（PEG）对已知或疑似克罗恩病（CD）患者及非CD患者小肠胶囊内镜检查可视化质量（VQ）的影响。
这项观察性、前瞻性、单中心研究纳入了2007年至2008年间连续接受小肠胶囊内镜检查的患者。患者分别在小肠胶囊内镜检查前12小时和1小时口服2升PEG和80毫克西甲硅油进行标准肠道清洁准备（A组），或仅口服PEG（B组）。记录基于小肠图像中管腔内气泡评分、检查完整性、小肠胶囊内镜检查诊断率、胃和小肠通过时间的VQ。
最终纳入的115例患者（A组n = 56，B组n = 59）中，103例（89.6%）可见盲肠。西甲硅油总体上改善了近端肠道的VQ[比值比：2.43（95%置信区间：1.08 - 5.45），P = 0.032]，但对远端肠段没有改善（P = 0.064）。然而，在已知或疑似患有CD的患者进行小肠胶囊内镜检查时未观察到这种效果。
西甲硅油作为PEG的辅助剂用于接受小肠胶囊内镜检查患者的肠道准备，可显著改善非CD患者的VQ。
