补充西甲硅油对结肠镜检查中腺瘤检出率的影响：一项随机对照试验的荟萃分析。
Effect of supplemental simethicone for bowel preparation on adenoma detection during colonoscopy: A meta-analysis of randomized controlled trials.
机构信息
Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China.
Department of Gastroenterology, The Second Clinical Medical College, Jinan University, Shenzhen, China.
出版信息
J Gastroenterol Hepatol. 2019 Feb;34(2):314-320. doi: 10.1111/jgh.14401. Epub 2018 Aug 27.
BACKGROUND AND AIM
Although several randomized controlled trials (RCTs) have reported that supplemental simethicone (SIM) can improve bowel preparation based on polyethylene glycol, there is no consensus as to whether SIM can ultimately increase the adenoma detection rate (ADR) during colonoscopy. A meta-analysis was performed to assess the effect of SIM on ADR during colonoscopy.
METHODS
Databases including PubMed, EMBASE, and the Cochrane Library were searched to find relevant RCTs. RCTs evaluating the effect of pre-procedure SIM on the ADR during colonoscopy were finally included, and fixed effect models were applied.
RESULTS
Six trials involving 1855 patients were finally included. The present meta-analysis suggested that the ADR during colonoscopy was significantly increased by supplemental SIM (27.9% vs 23.3%, P = 0.02), with a relative risk of 1.20 (95% confidence interval 1.03-1.39). Subgroup analysis suggested that supplemental SIM may be more useful to improve ADR during colonoscopy in endoscopic centers with low baseline ADR.
CONCLUSIONS
Supplemental SIM for bowel preparation based on polyethylene glycol is useful to improve the ADR during colonoscopy.
背景与目的
尽管几项随机对照试验（RCT）报道，补充二甲硅油（SIM）可以改善基于聚乙二醇的肠道准备，但 SIM 是否最终可以提高结肠镜检查中的腺瘤检出率（ADR），尚未达成共识。进行了一项荟萃分析，以评估 SIM 对结肠镜检查中 ADR 的影响。
方法
检索包括 PubMed、EMBASE 和 Cochrane 图书馆在内的数据库，以查找相关 RCT。最终纳入了评估术前 SIM 对结肠镜检查中 ADR 影响的 RCT，并应用固定效应模型。
结果
最终纳入了 6 项涉及 1855 名患者的试验。本荟萃分析表明，补充 SIM 可显著提高结肠镜检查中的 ADR（27.9% vs 23.3%，P = 0.02），相对风险为 1.20（95%置信区间 1.03-1.39）。亚组分析表明，在 ADR 基线较低的内镜中心，补充 SIM 可能更有助于提高结肠镜检查中的 ADR。
结论
基于聚乙二醇的肠道准备中补充 SIM 有助于提高结肠镜检查中的 ADR。
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