Chen Hong-Bin, Lian-Xiang Peng, Yue Huang, Chun Huang, Shu-Ping Xiao, Rong-Pang Lin, Xiao-Zong Wang, Xiao-Lin Li
Department of Gastroenterology, Sanming First Hospital Affiliated to Fujian Medical University, Sanming Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzou Department of Cardiology, Fu Wai Hospital of Chinese Academy of Medical Sciences of Peking Union Medical College, Peking, China.
Medicine (Baltimore). 2017 Oct;96(43):e8322. doi: 10.1097/MD.0000000000008322.
The approach to small bowel preparation before capsule endoscopy (CE) is still suboptimal.
One hundred eighty patients were randomly allocated to 3 groups. Patients in Group A took 250 mL 20% mannitol and 1 L 0.9% saline orally at 05:00 hours on the day of the procedure. In Group B the same preparation was taken at 20:00 on the day before, and at 05:00 on the day of CE; in addition, 20 mL oral simethicone was taken 30 minutes before CE. Group C was treated identically to Group B, except that the patients fasted for 3 days and took 3 g senna orally 3 times daily before CE. The length of bowel containing green luminal contents was assessed by ImageJ software and bowel cleanliness was evaluated by computed assessment of the cleansing score.
Cleansing of the whole small bowel and the distal small bowel were significantly different between the 3 groups (χ = 22.470, P = .000; χ = 17.029, P = .000, respectively). There were also significant differences between the 3 groups in the length of small bowel and specifically the length of the distal small bowel containing green luminal contents (χ = 12.390, P = .000, χ = 15.141, P = .000, respectively), but not with regard to the proximal small bowel (χ = 0.678, P = .509).
Three days fasting and oral senna, combined with 20% mannitol and simethicone, before CE, can reduce the effects of bile on the small bowel and improve small bowel cleansing, especially in the distal small intestine.
胶囊内镜检查（CE）前的小肠准备方法仍不尽人意。
180例患者随机分为3组。A组患者在检查当天05:00口服250毫升20%甘露醇和1升0.9%生理盐水。B组在检查前一天20:00以及检查当天05:00进行相同的准备；此外，在CE检查前30分钟口服20毫升西甲硅油。C组治疗与B组相同，但患者在CE检查前禁食3天，每天口服3克番泻叶3次。通过ImageJ软件评估含有绿色肠腔内容物的肠段长度，并通过计算清洁评分评估肠道清洁度。
3组在整个小肠和远端小肠的清洁情况上存在显著差异（χ = 22.470，P = 0.000；χ = 17.029，P = 0.000）。3组在小肠长度尤其是含有绿色肠腔内容物的远端小肠长度上也存在显著差异（χ = 12.390，P = 0.000；χ = 15.141，P = 0.000），但在近端小肠方面无显著差异（χ = 0.678，P = 0.509）。
在CE检查前禁食3天并口服番泻叶，联合20%甘露醇和西甲硅油，可减少胆汁对小肠的影响，改善小肠清洁度，尤其是在远端小肠。
