胃蛋白酶预处理在内镜超声检查中的作用：一项随机对照试验。

Effects of premedication with Pronase for endoscopic ultrasound of the stomach: A randomized controlled trial.

作者信息

Wang Guo-Xin, Liu Xiang, Wang Sheng, Ge Nan, Guo Jin-Tao, Sun Si-Yu

机构信息

Guo-Xin Wang, Xiang Liu, Sheng Wang, Nan Ge, Jin-Tao Guo, Si-Yu Sun, Endoscopy Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.

出版信息

World J Gastroenterol. 2016 Dec 28;22(48):10673-10679. doi: 10.3748/wjg.v22.i48.10673.

DOI:10.3748/wjg.v22.i48.10673

PMID:28082820

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5192279/

Abstract

AIM

To analyze the effects of premedication with Pronase for endoscopic ultrasound (EUS) examination of the stomach.

METHODS

This was a prospective, randomized and controlled clinical study. All patients were randomly assigned to either the Pronase group or placebo group. The pretreatment solution was a mixed solution of 20000 U of Pronase and 60 mL sodium bicarbonate solution in the Pronase group, while an equal amount of sodium bicarbonate solution was administered to the placebo group. All operators, image evaluators and experimental recorders in EUS did not participate in the preparation and allocation of pretreatment solution. Two blinded investigators assessed the obscurity scores for the EUS images according to the size of artifacts (including ultrasound images of the gastric cavity and the gastric wall). Differences in imaging quality, the duration of examination and the usage of physiological saline during the examination process between the Pronase group and the control group were compared.

RESULTS

No differences existed in patient demographics between the two groups. For the gastric cavity, the Pronase group had significantly lower mean obscurity scores than the placebo group (1.0476 ± 0.77 1.6129 ± 0.96, respectively, = 0.000). The mean obscurity scores for the gastric mucosal surface were significantly lower in the Pronase group than the placebo group (1.2063 ± 0.90 1.7581 ± 0.84, respectively, = 0.001). The average EUS procedure duration for the Pronase group was 11.60 ± 3.32 min, which was significantly shorter than that of the placebo group (13.13 ± 3.81 min, = 0.007). Less saline was used in the Pronase group than the placebo group, and the difference was significant (417.94 ± 121.38 mL 467.42 ± 104.52 mL, respectively, = 0.016).

CONCLUSION

The group that had Pronase premedication prior to the EUS examination had clearer images than the placebo group. With Pronase premedication, the examination time was shorter, and the amount of saline used during the EUS examination was less.

摘要

目的

分析胃蛋白酶预处理在内镜超声（EUS）检查胃中的作用。

方法

这是一项前瞻性、随机对照临床研究。所有患者被随机分为胃蛋白酶组或安慰剂组。胃蛋白酶组的预处理溶液为20000 U胃蛋白酶与60 mL碳酸氢钠溶液的混合溶液，而安慰剂组给予等量的碳酸氢钠溶液。EUS的所有操作人员、图像评估人员和实验记录人员均未参与预处理溶液的配制和分配。两名盲法研究者根据伪像大小（包括胃腔和胃壁的超声图像）评估EUS图像的模糊度评分。比较胃蛋白酶组和对照组在成像质量、检查持续时间以及检查过程中生理盐水使用量方面的差异。

结果

两组患者的人口统计学特征无差异。对于胃腔，胃蛋白酶组的平均模糊度评分显著低于安慰剂组（分别为1.0476±0.77和1.6129±0.96，P = 0.000）。胃蛋白酶组胃黏膜表面的平均模糊度评分显著低于安慰剂组（分别为1.2063±0.90和1.7581±0.84，P = 0.001）。胃蛋白酶组的平均EUS检查持续时间为11.60±3.32分钟，显著短于安慰剂组（13.13±3.81分钟，P = 0.007）。胃蛋白酶组使用的生理盐水少于安慰剂组，差异有统计学意义（分别为417.94±121.38 mL和467.42±104.52 mL，P = 0.016）。