莫沙比利分散片在OMOM胶囊内镜检查中的应用研究

目的探讨口服莫沙比利分散片对胶囊内镜检查中胃肠转运时间、全小肠检查完成率及胶囊内镜诊断率的影响。方法将30例患者随机分为服药组(15例)和对照组(15例),所有患者检查前1天晚餐进流质后禁食。两组患者均在检查前5 h行肠道准备。服药组检查前15 min口服莫沙比利分散片5 mg,对照组检查前不服用任何药物。结果服药组平均胃排空时间为27±18 min,对照组为:65±25 min,两组比较差异有统计学意义(P<0.05)。完成全小肠检查者通过时间服药组平均为’240±45 min,对照组平均为290±60 min,两组比较差异无统计学意义(P﹥0.05)。全小肠检查完成率服药组为93.3%,对照组为73.3%,两组比较差异有统计学意义(P<0.05)。胶囊内镜诊断率服药组为80.0%,对照组为66.7%,两组差异有统计学意义(P<0.05)。结论胶囊内镜检查前给予口服莫沙比利可以缩短胃排空时间,可能提高全小肠检查完成率和胶囊内镜诊断率。对年老体弱、胃动力不足的受检者,胶囊内镜检查前口服莫沙比利,可以提高胶囊内镜诊断率。     

莫沙必利在便秘患者胶囊内镜检查中的应用价值

目的 探讨便秘思者作胶曩内镜检查前口服莫沙必利的临床价值.方法 30例思者采用随机数字表法均分人治疗组和观察组,治疗组检查前1周口服莫沙必利片,检查当日两组肠道准备相同,比较两组首次大便时间、大便次数、大便清澈时间、胃转运时间、小肠转运时间、小肠清洁度及胶囊排出时间.结果 治疗组首次大便时间为69min,明显短于对照组（89min,P＜0.05）大便清洁时间为153min,明显短于对照组（176min,P＜0.05）;排便次数平均为8.8次,多于对照组（平均4.5次,P＜0.05）;治疗组胃内转运时间平均为29min,明显短于对照组（平均57min,P＜0.05）;小肠转运时间平均为235min,明显短于对照组（平均299min,P＜0.05）;治疗组小肠清洁度平均为2.44分,明显好于对照组（1.97分,P＜0.05）,胶囊排出时间治疗组为21h,明显快于对照组（28h）.结论 便秘患者作胶囊内镜检查前口服莫沙必利具有较好的临床价值.     

复方聚乙二醇电解质散与西甲硅油在胶囊内镜肠道检查中的应用

目的探讨复方聚乙二醇电解质散(PEG)与西甲硅油在胶囊内镜肠道检查前肠道准备应用效果。方法将2016年10月至2018年10月于江苏大学附属昆山市第一人民医院行胶囊内镜肠道检查的90例患者随机分为A组(PEG)与B组(PEG+西甲硅油),各45例。比较两组肠道清洁程度、肠道内气泡存在程度、胶囊通过胃及小肠的时间和不良反应发生率。结果两组肠道清洁程度比较,差异无统计学意义(P0. 05)。B组肠道内气泡存在程度显著低于A组(P 0. 05)。B组胶囊通过胃、小肠的时间分别为(37. 60±8. 28) min、(280. 62±56. 33) min,显著短于A组的(45. 80±9. 13) min、(333. 58±67. 52) min,差异均有统计学意义(P 0. 05)分。B组不良反应发生率为6. 67%,显著低于A组的22. 22%(P 0. 05)。结论胶囊内镜检查前联合应用PEG与西甲硅油可有效祛除肠腔内气泡,获得良好的视野,缩短胶囊通过胃及小肠的时间,且不良反应发生率低,具有较高的应用安全性。     

促胃肠动力药在胶囊内镜检查中的作用研究

目的探讨胶囊内镜检查前口服促胃肠动力药对胶囊内镜检查中胃肠转运时间、检查完成率及诊断率的影响。方法将2004年9月至2005年9月间因疑似小肠疾病的患者60例纳入本研究，随机分为2组，每组30例。服药组胶囊内镜检查前口服促胃肠动力药莫沙比利10mg，对照组则不服药物。记录胶囊内镜检查中的胃肠转运时间，比较两组全小肠检查完成率及诊断阳性率。结果服药组平均胃排空时间为29min（2～133min），短于对照组的54min（2～275min）（P=0．035）；两组小肠通过时间（248min vs．281min）差异无统计学意义（P=0．3492）；服药组完成全小肠检查率（93．3％）高于对照组（66．7％）（P=0．021）；服药组胶囊内镜诊断率（73．3％）与对照组（50％）相比差异无统计学意义（P=0．11）。结论胶囊内镜检查前口服促胃肠动力药能缩短胃排空时间，提高全小肠检查完成率。     

术前肌注甲氧氯普胺在胶囊内镜检查中的作用分析

[目的]探讨胶囊内镜检查术中检查前患者肌注甲氧氯普胺的临床价值。[方法]170例疑似小肠疾病患者采用随机数字表法均分入观察组和对照组,检查当日2组肠道准备相同,观察组术前肌注甲氧氯普胺;比较2组胶囊内镜胃转运和小肠转运时间以及病变检出率的差异。[结果]观察组平均胃转运时间为(20.1±5.2)min,明显低于对照组的(36.2±7.6)min(P0.05);平均小肠转运时间为(258±4.9)min,明显低于对照组的(264±3.5)min(P0.05);小肠病变检出率为80%,明显高于对照组的60%(P0.05)。[结论]胶囊内镜检查前患者肌注甲氧氯普胺具有缩短检查时间及提高病变检出率的效果。     

胶囊内镜检查中祛泡剂最佳应用时机的效果分析

目的重点观察祛泡剂在胶囊内镜检查中最佳应用时机选择后的应用效果。方法 300例在北京军区总医院消化内镜中心接受胶囊内镜检查的患者,随机分成3组:A组(100例):口服胶囊内镜前45 min时服用祛泡剂30 ml;B组(100例):口服胶囊内镜前30 min时服用祛泡剂30 ml;C组(100例):口服胶囊内镜前15 min服用祛泡剂30 ml。比较3组患者胃、小肠及结肠内的气泡量、图像清晰度、肠道清洁满意度和阅片医师满意度,并观察有无不良反应。结果 3组患者均无不良反应发生,A组胃腔、小肠肠道和结肠肠道内气泡量少,影像清晰度好,阅片医师满意度最好,其胶囊内镜图像清晰度、肠道清洁程度和病变发现率优于B组和C组,差异有统计学意义(P0.01)。结论胶囊内镜检查前45 min服用祛泡剂可以充分祛除胃、小肠和结肠内的气泡和黏液,明显提高胶囊内镜检查的影像清晰度、肠道清洁程度和病变发现率,阅片医师满意度好。     

OMOM胶囊内镜在无症状人群体检中的应用

目的 探讨OMOM胶囊内镜在无症状人群体检中应用价值.方法 受检者为2005年8月-2010年3月到北京军区总医院消化内科进行胶囊内镜检查的无症状体检人群,受检者按就诊的时间顺序随机分为研究组(A组)、对照组(B组)、自身对照组(C组).A组受检者按一定体位进行胶囊内镜检查,送服胶囊后立即依次平卧位3 min,左侧卧位3 min,右侧卧位3 min,半卧位3min,观察食管黏膜情况,再观察胃依次左侧卧位10 min,平卧位10 min,右侧卧位10 min,站立位10 min,随后可自由活动,直至胶囊内镜排出体外.B组受检者按常规要求进行胶囊内镜检查.C组受检者进行胶囊内镜检查后即安排胃镜和结肠镜检查.结果 A组和B组胶囊内镜食管运行平均时间和胃排空平均时间差异均有统计学意义(P＜0.05);但A组和B组胶囊内镜排出平均时间差异无统计学意义(P＞0.05).A组和C组胶囊内镜食管运行平均时间和排出平均时间差异均有统计学意义(P＜0.05);但A组和C组胶囊内镜胃排空平均时间差异无统计学意义(P＞0.05).90例A组受检者中检出消化道病变者28例,检出率31.11％;160例B组受检者中检出消化道病变者42例,检出率26.25％;110例C组受检者中检出消化道病变者43例,检出率39.09％.A组和B组食管病变检出率比较差异具有统计学意义(P＜0.05).结论 胶囊内镜在特定体位下可以提高食管及胃病变检出率.胶囊内镜检查可以指导胃镜及结肠镜检查能更有效提高消化道疾病检出率,用于无症状人群体检无疑是一种安全、无创、无痛苦的消化道检查方法.     

链霉蛋白酶与利多卡因胶浆联用提高超声内镜检查清晰度的研究

目的评价检查前联合使用链霉蛋白酶和利多卡因胶浆对缩短超声胃镜操作时间和改善内镜、超声图像方面的效果。方法将超声内镜受检者80例随机分为A、B组,每组40例。A组于检查前15min口服利多卡因胶浆10ml;B组于检查前30rain口服含10000单位链霉蛋白酶和1g碳酸氢钠的温开水50ml,并于检查前15min口服利多卡因胶浆10ml。记录总操作时间,并对超声胃镜下胃内黏液附着量及超声图像的清晰度进行评分。结果A组操作时间长于B组[（15．5±3．0）min比（12．3±2．3）min,P〈0．001],B组内镜和超声内镜图像视野清晰度均优于A组。结论链酶蛋白酶和利多卡因胶浆联用可有效去除胃内黏液艉高超声内镜检查成像质量。     

复方聚乙二醇电解质散与西甲硅油在胶囊内镜肠道准备中的时间及剂量研究

目的探讨分析复方聚乙二醇电解质散与西甲硅油在胶囊内镜肠道准备中的时间及剂量,选择最佳肠道准备方案。方法选取2015年1月至2017年8月惠州市第一人民医院接受胶囊内镜检查的患者82例,随机分为A组和B组。A组检查前48 h分次口服西甲硅油,检查前4 h服用聚乙二醇电解质散2 000 m L;B组检查前0.5 h一次性口服30m L西甲硅油,检查前4 h服用聚乙二醇电解质散3 000 m L。比较两组肠道清洁度、视野清晰度评分,胶囊通过胃、小肠时间,肠道准备满意度评价,耐受情况。结果 A组患者肠道清洁度、视野清晰度评分均显著优于B组(P0.05)。两组胶囊通过胃、小肠时间差异均无统计学意义(P0.05)。A、B组肠道准备满意率分别为95.12%、46.34%,A组患者肠道准备满意度明显优于B组(P0.05)。A组恶心、呕吐、腹胀、腹痛评分显著低于B组(P0.05)。结论胶囊内镜检查前48 h分3次服用30 m L西甲硅油祛泡效果更佳,检查前4 h服用2000 m L复方聚乙二醇电解质散清肠效果更佳,可提高检查图像质量和诊断的检出率,值得在临床上推广。     

伊托必利在胶囊内镜检查中的应用价值

背景:胶囊内镜检查是小肠疾病的首选诊断方法,肠道清洁度、胃肠动力等是影响检查质量的关键因素。目的:探讨伊托必利在胶囊内镜检查中的应用价值。方法:连续纳入2014年8月—2015年10月于重庆市垫江县人民医院因疑似小肠疾病而行胶囊内镜检查的患者80例,随机分为试验组和对照组。试验组检查前1 d口服伊托必利50 mg tid,肠道准备前30 min口服伊托必利50 mg。两组均服用聚乙二醇电解质散溶液行肠道准备,观察导泻情况、胶囊胃肠转运时间、小肠清洁度和病变检出情况。结果:试验组首次排便时间和排便清洁时间短于对照组,排便次数多于对照组,不良反应发生率低于对照组,差异均有统计学意义(P0.05)。试验组胶囊胃转运时间显著短于对照组(P0.05),胶囊小肠转运时间、小肠清洁度和病变检出率与对照组相比无明显差异(P0.05)。结论:胶囊内镜检查肠道准备前预服伊托必利可缩短肠道准备时间,提高患者依从性,并缩短胶囊胃转运时间以保证小肠检查时间充足,具有较好的临床应用价值。     

Effect of oral erythromycin on gastric and small bowel transit time of capsule endoscopy

AIM: To determine the effect of oral erythromycin on gastric and small bowel transit time of capsule endoscopy. METHODS: Consecutive patients who underwent capsule endoscopy dgring the 16-mo study period were either given 250 mg oral erythromycin, 1 h prior to swallowing the capsule endoscope or nothing. The gastric and small bowel transit time, and the small bowel image quality were compared. RESULTS: Twenty-four patients received oral erythromycin whereas 14 patients were not given any prokinetic agent. Patients who received erythromycin had a significantly lower gastric transit time than control (16 min vs70 min, P= 0.005), whereas the small bowel transit time was comparable between the two groups (227 min vs 183 min, P= 0.18). Incomplete small bowel examination was found in three patients of the control group and in one patient of the erythromycin group. There was no significant difference in the overall quality of small bowel images between the two groups. A marked reduction in gastric transit time was noted in two patients who had repeat capsule endoscopy after oral erythromycin. CONCLUSION: Use of oral erythromycin significantly reduces the gastric transit time of capsule endoscopy.     

Effect of mosapride on gastrointestinal transit time and diagnostic yield of capsule endoscopy

BACKGROUND AND AIM: Since its introduction, capsule endoscopy (CE) has made it possible to visualize the small intestine mucosa directly. However, owing to the limited battery life, only 60-80% of the capsules could reach the cecum and would possibly affect the diagnostic yield. The aim of this study was to determine the effect of oral mosapride on gastrointestinal transit time and the diagnostic yield of CE. METHOD: Sixty patients were involved in this randomized, prospective and controlled study. The patients were randomly allocated to groups receiving either mosapride citrate or nothing. Patients in the mosapride group (n = 30) received 10 mg mosapride citrate 1 h before CE examination, while patients in the control group (n = 30) received no preparation. The gastrointestinal transit time, the number of CE reaching the cecum, and the diagnostic yield of each group were assessed in a single-blinded fashion. RESULT: Gastric emptying time was significantly shorter in the mosapride group than in the control group (13.5 min vs 34 min P = 0.035). Compared with the control group, the complete transit rate was significantly higher in the mosapride group (93.3% vs 66.7% P = 0.021). There was no significant difference between the two groups on the small bowel transit time and diagnostic yield. CONCLUSION: Mosapride citrate accelerates the gastric emptying and completion rate of small bowel examination in patients undergoing CE.     

Effect of erythromycin on image quality and transit time of capsule endoscopy： A two-center study

AIM： To compare the effect of oral erythromycin vs no preparation with prokinetics on the transit time and the image quality of capsule endoscopy （CE） in evaluating small bowel （SB） pathology. METHODS： We conducted a retrospective, blinded （to the type of preparation） review of 100 CE studies, 50 with no preparation with prokinetics from one medical center （Group A） and 50 from another center with administration of a single dose of 200 mg oral erythromycin 1 h prior to CE （Group B）. Gastric, SB and total transit times were calculated, the presence of bile in the duodenum was scored, as was cleanliness within the proximal, middle and distal intestine. RESULTS： The erythromycin group had a slightly shorter gastric transit time （21 min vs 28 min, with no statistical significance）. SB transit time was similar for both groups （all P 〉 0.05）. Total transit time was almost identical in both groups. The rate of incomplete examination was 16% for Group A and 10% for Group B （P = 0.37）. Bile and cleanliness scores in different parts of the intestine were similar for the two groups （P 〉 0.05）. CONCLUSION： Preparation for capsule endoscopy with erythromycin does not affect SB or total transit time. It tends to reduce gastric transit time, but it does not increase the cecum-reaching rate. Erythromycin does not adversely affect image quality. We consider the routine use of oral erythromycin preparation as being unjustified, although it might be considered in patients with known prolonged gastric emptying time.     

Is a 2-liter PEG preparation useful before capsule endoscopy?

AIMS: Small bowel contents can sometimes hamper the quality of capsule images. Our aim was to investigate the effect of PEG administered prior to capsule endoscopy (CE) upon quality of images, gastrointestinal transit time, and detection rate of small bowel bleeding lesions in patients with obscure gastrointestinal bleeding. PATIENTS AND METHODS: Forty-two consecutive patients were included. CE was performed following a 12-hour fasting period. The 16 first patients (Group A) received no preparation and the following 27 patients (Group B) received 2 L of PEG the night before. The quality of images was assessed at both in duodenojejunum and ileum level, using a scale including the presence of air bubbles, biliary secretion, and residue (1-4). RESULTS: Quality of images were not different in Group A compared with Group B in the duodenojejunum and in the ileum. Gastric transit time tended to be shorter in Group A compared with Group B (25.5 vs. 45.7 minutes) (P = 0.15), whereas small bowel transit was not different between both groups (271 vs. 288 minutes). Total small bowel CE examination was complete in Group A and in 24 of 26 in Group B (not significant). Potential bleeding lesions were seen in 8 patients in Group A and 12 in Group B (not significant). CONCLUSION: Our retrospective study suggests that 2 L PEG preparation seems able to improve neither the quality of CE images nor its diagnostic performance. Moreover, in our study, PEG tended to increase gastric emptying time and may constitute a limitation for small bowel complete examination.     

无痛胃镜肠镜与胶囊内镜检查同日进行的可行性探讨

[目的]探讨无痛胃镜肠镜与胶囊内镜检查同日进行的可行性。[方法]接受胶囊内镜检查的患者中,32例为同日接受无痛胃镜肠镜检查后、接着行胶囊内镜检查的患者(同日组),81例为先行电子胃肠镜检查后、择日只接受胶囊内镜检查的患者(择日组)。观察2组胶囊的运行时间,病变检测率,不良反应。[结果]胃内运行的平均时间:同日组为(30.75±35.97)min,择日组(31.81±32.13)min,2组比较差异无统计学意义(P0.05);小肠内运行的平均时间:同日组(294.97±122.55)min,择日组(267.87±117.82)min,2组比较差异无统计学意义(P0.05)。2组均未发生无不良反应,无一例发生胶囊滞留。[结论]胶囊内镜检查操作安全、无创伤,有较高的诊断价值,与无痛胃镜、肠镜同日执行是可行的,并可避免多次肠道准备带来的不适。     

Clinical impact of a newly developed capsule endoscope: usefulness of a real-time image viewer for gastric transit abnormality

Background A new capsule endoscope has been developed by Olympus Medical Systems. The visualization and usefulness of its real-time image viewer for gastric transit abnormality were evaluated by using this new device. Methods Thirty-seven consecutive patients were enrolled. In cases of gastric transit abnormality (gastric transit > 60 min, detected by the real-time viewer), intramuscular metoclopramide (10 mg) was administered. Diagnostic yield and gastric and small bowel transit times in ten patients receiving (group A) and 27 not receiving (group B) metoclopramide were analyzed. Results Median gastric transit time was longer in group A than in group B (110 vs. 24 min; P < 0.0001). Conversely, median small bowel transit time was shorter in group A than in group B (270 vs. 347 min; P < 0.05). Further, small bowel transit was complete in 9/10 patients (90%) in group A, and in 23/27 patients (85%) in group B, but the difference was not significant. Overall diagnostic yield was 78% (29/37 patients), and there was no significant difference in the ratio of abnormal findings documented between group A (8/10, 80%) and group B (21/27, 78%) patients. Conclusions This new technology allowed clear image interpretation, and the real-time viewer was useful for detecting gastric transit abnormalities and determining a need for metoclopramide administration in patients undergoing capsule endoscopy.     

Effects of the oral administration of mosapride citrate on capsule endoscopy completion rate

Background/Aims

In capsule endoscopy (CE), the capsule does not always reach the cecum within its battery life, which may reduce its diagnostic yield. We evaluated the effect of mosapride citrate, a 5-hydroxytryptamine-4 agonist that increases gastrointestinal motility, on CE completion.

Methods

In a retrospective study, we performed univariate and multivariate analyses for 232 CE procedures performed at our hospital. To identify factors that affect CE completion, the following data were systematically collected: gender, age, gastric transit time (GTT), nonsteroidal anti-inflammatory drug administration, previous abdominal surgery, hospitalization, use of a polyethylene glycol solution, use of mosapride citrate (10 mg), body mass index (BMI), and total recording time.

Results

The univariate analysis showed that oral mosapride citrate, GTT, and BMI were associated with improved CE completion. Multivariate analyses showed that oral mosapride citrate (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.01 to 3.91) and GTT (OR, 2.34; 95% CI, 1.13 to 4.87) were significant factors for improving the CE completion. Oral mosapride citrate significantly shortened the GTT and small bowel transit time (SBTT).

Conclusions

Oral mosapride citrate reduced the GTT and SBTT during CE and improved the CE completion rate.     

Purgative bowel cleansing combined with simethicone improves capsule endoscopy imaging

AIM: To evaluate the effects of the various methods of small bowel preparation on the quality of visualization of the small bowel and the gastrointestinal transit time of capsule endoscopy (CE). METHODS: Ninety patients referred for CE were prospectively randomized to three equal groups according to the preparation used: (a) a control group, in which patients were requested to drink 1 L of clear liquids only, 12 h before the examination; (b) a purgative group, in which patients were requested to ingest 1 L of a polyethylene glycol (PEG)/electrolyte solution only, 12 h before the examination; or (c) a purgative combined with simethicone group (P-S group), in which patients were requested to ingest 1 L of PEG, 12 h before the examination, and 300 mg of simethicone, 20 min before the examination. Effects of the different bowel preparations on the gastric transit time (GTT), small bowel transit time (SBTT), examination completion rate, quality of images of the entire small intestine, and cleansing of the proximal small bowel and distal ileum were evaluated. RESULTS: The number of patients with "adequate" cleansing of the entire small intestine was 17 in the P-S group, 12 in the purgative group, and seven in the control group (P= 0.002). The P-S group had significantly better image quality than the control group (P= 0.001). The P-S group had significantly better image quality for the proximal small bowel (segment A [Seg A]) than the control group (P= 0.0001). Both the P-S group (P= 0.0001) and the purgative group (P= 0.0002) had significantly better image quality for the distal ileum (segment B [Seg B]) than the control group; the P-S group had significantly better image quality than the purgative group as well (P= 0.0121). Gastrointestinal transit time was not different among the three groups, nor was the examination completion rate. CONCLUSIONS: Purgative bowel cleansing combined with simethicone before CE improved the quality of imaging of the entire small bowel as well as the visualization of the mucosa in the proximal and distal small intestine.