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。     

实时监控系统在胶囊内镜检查干预过程中的应用价值观察

目的探讨胶囊内镜实时监控系统在胶囊内镜检查干预过程中的应用价值及其对全小肠检查完成率的影响。方法对2007年3月-2008年8月问因疑似小肠疾病而行胶囊内镜检查的120例患者应用实时监控系统进行视频追踪,并对幽门通过时间延迟者使用胃镜及圈套器将胶囊内镜直接送入十二指肠以减少其在食管和胃内的滞留时间;与2002年5月-2007年2月问以传统检查方式接受胶囊内镜检查的329例患者进行胶囊内镜幽门通过时间、小肠转运时间以及全小肠检查完成率的比较。结果传统检查组与实时监控组比较,胶囊内镜幽门通过中位数时间（30min对34min,P=0．787）及小肠转运时间[（275±100）min对（289±96）min,P=0．256）]差异均无统计学意义。实时监控组中胶囊内镜全小肠检查完成率显著高于传统检查组（84．2％对73．6％,P=0．019）。结论实时监控系统可及时发现检查过程中的异常现象,并指导内镜医生准确地实施临床干预,在其监测下进行干预可提高全小肠检查完成率。     

胃肠动力药物在60例小肠胶囊内镜检查中的作用观察

目的 探讨胃肠动力药物对胶囊内镜检查中胶囊通过胃的时间、通过全小肠的时间的影响。方法收集2011年10月至2012年10月在我院行小肠胶囊内镜检查的60例患者,平均分成三组,A组检查前10min口服多潘立酮10mg,B组检查前10min口服莫沙比利10mg,C组检查前不服用任何药物。结果A组胶囊平均通过胃时间为24min±15min,B组平均通过胃时间为27min±20min,C组平均通过胃时间为45min±33min,多潘立酮、莫沙必利可以缩短胶囊在胃内的停留时间（P〈0．05）;A组胶囊平均通过小肠时间为6h±1h50min,B组平均通过小肠时间为3h40min±2h11min,C组平均通过小肠时间为6h30min±2h12min,B组与A组比较、B组与C组比较差异有统计学意义（P〈0．05）,A组与C组比较差异无统计学意义（P〉0．05）。结论胶囊内镜检查前给予口服胃肠动力药可缩短胶囊在胃内的停留时间;胶囊内镜检查前给予口服莫沙必利可缩短胶囊通过全小肠的时间。     

胶囊内镜消化道转运时间影响因素分析陈霖王春晖胡仁伟等

背景：PY囊内镜因具有良好的安全性、耐受性和有效性，目前已广泛应用于小肠疾病的诊断，能否在电池耗尽前完全通过小肠是决定胶囊内镜检查成功与否的关键因素之一。目的：探讨胶囊内镜消化道转运时间的影响因素。方法：对2009年1月-2012年12月于华西医院接受胶囊内镜检查的426例连续病例进行回顾性分析。以Cox比例风险回归模型分析胶囊内镜胃转运时间（GTF）和小肠转运时间（SBTT）的影响因素。结果：319例受检者完成全段小肠检查，检出病变317例，中位GTT和SBTT分别为33．3min和330．5min。在性别、年龄、小肠清洁程度和阳性诊断四个变量中，年龄与GTT呈正相关（OR=1．007，95％CI：1．001～1．013，P=0．032），小肠清洁程度与GTF（OR=0．874，95％CI：0．768-0．994，P=0．040）和SBTT（OR=0．769，95％CI：0．640-0．924，P=0．005）呈负相关。62例受检者胶囊内镜滞留于胃中，其中61例经口服多潘立酮片或胃镜推送后进入小肠。结论：较好的小肠清洁程度能缩短胶囊内镜的消化道转运时间。检查中应实时监测胶囊内镜通过情况，必要时可采取口服促动力药或胃镜推送以获得更短的转运时间。     

胶囊内镜在诊断老年患者小肠疾病中的应用

目的探讨胶囊内镜在老年患者小肠疾病中的诊断价值和安全性。方法回顾性分析2003年5月至2009年7月接受胶囊内镜检查的老年患者（≥60岁）资料,并和同期非老年患者（〈60岁）进行比较。结果32例老年患者中有31例（96．9％）完成胶囊内镜检查,全小肠检查完成率和非老年组相比差异无统计学意义（P=0．39）,两组胃排空时间差异无统计学意义（P=0．091）,但老年患者的小肠转运时间长于非老年患者（P=0．028）。31例老年患者的小肠病变枪出率为48．4％,两组差异无统计学意义（P=0．643）,老年患者小肠以血管病变为主（52．9％）,而非老年患者最常见的是克罗恩病（29．6％）。结论胶囊内镜对老年患者小肠疾病是一项有效、安全的检查方法。     

干预因素在胶囊内镜检查中的作用评价

胶囊内镜是一种非常有用的检测小肠疾病的工具，诊断率约为60％。但因受其电池供电量的限制和肠道内不洁等因素的影响，临床胶囊内镜全小肠检查的未完成率达20％左右，各研究的诊断率亦不尽一致。促胃肠动力药、术前肠道准备应用于胶囊内镜检查是否能提高其检查完成率和图像质量，进而提高对小肠疾病的诊断率，目前尚存在争议。本文就各种应用于胶囊内镜检查的干预因素作一综述。     

影响胶囊内镜检查完成率的相关因素分析

目的通过观察胶囊内镜全小肠检查完成率（small-bowelcompletionrate,SMCR）,并对其影响因素进行分析。方法回顾分析2010年3月至2012年3月我院102例患者胶囊内镜检查情况。结果79例患者完成全小肠检查。其中,胃平均通过时间（gastrictransittime,GTT）为48．5min．小肠平均通过时间（small—boweltransittime．SMTT）278．3min;年龄、胃通过时间大于90min为影响胶囊内镜检查完成率的因素（P〈0．05）。结论年龄、胃通过时间对胶囊内镜检查完成率有影响。对于年龄大于60岁、GTT延长超过90min者需提前干预,提高胶囊内镜完成率。     

复方褐藻胶囊对大鼠胃排空及小肠推进功能的作用

目的研究复方褐藻胶囊对大鼠胃肠动力功能的作用。方法将16只大鼠分为2组。复方褐藻胶囊组（n=8）大鼠经导管灌入胃内复方褐藻＋美兰＋131碘－碘马尿酸，测定初始放射性剂量和45min后胃内的放射性剂量，计算胃排空率．量取幽门括约肌至美兰最前端及盲肠的距离，其比值为小肠推进比．对照组（n＝8）只用美兰及131碘-碘马尿酸．结果复方褐藻胶囊组胃排空率为89．7％±3．43％，显著高于对照组的67．5％±4．18％（P＜0．01）．复方褐藻胶囊组的小肠推进比为80．7％±6．40％，也显著高于对照组的62．5％±6．49％（P＜0．01）．结论复方褐囊胶囊有促进大鼠胃排空和小肠推进功能的作用．     

实时干预对胶囊内镜全小肠检查完成率的影响

目的 探讨实时干预对胶囊内镜检查完成率的影响.方法 选取2011年3月-2014年1月深圳市罗湖区人民医院的104例患者,随机分为实验组和对照组,分别行胶囊内镜检查,实验组检查前肌注胃复安注射液10 mg,胶囊进入胃后实时监测,若胃通过时间（gastric transit time,GTT）超过90 min给予内镜干预推送胶囊通过幽门进入十二指肠;对照组检查前、检查过程中不作任何干预.结果 分析两组的GTT、小肠通过时间（small-bowel transit time,SBTT）及全小肠检查完成率的差异,发现GTT、SBTT及检查完成率两组比较差异均有统计学意义（P均＜0.05）,检查阳性率两组比较,差异无统计学意义（P＞0.05）.结论 实时干预可提高患者胶囊内镜全小肠检查完成率.     

实时监视下右侧卧位在胶囊内镜检查中的作用研究

目的 探讨实时监视下右侧卧位在胶囊内镜检查过程中的应用价值.方法 80例患者均分为两组,观察组取右侧卧位,对照组取直立位、站立或坐位均可,吞入胶囊内镜后实时监控胃内通过情况,通过幽门后患者可自由活动,统计分析两组间胃转运时间、小肠转运时间、全小肠检查完成率及阳性发现率差异.结果 观察组平均胃转运时间为(31.7 ±29.8)min,明显短于对照组的(62.6±55.9) min(U =559.000,P=0.020)；平均小肠转运时间为(221.3 ±78.8)min,与对照组的(211.1±86.2)min比较差异无统计学意义(t=0.511,P=0.611)；全小肠检查完成率为95.0％( 38/40),明显高于对照组的77.5％ (31/40)(x2=5.165,P=0.023)；阳性发现率为75.0％(30/40),与对照组的65.0％ (26/40)比较差异无统计学意义(x2=0.952,P=0.329).结论 实时监视下右侧卧位在胶囊内镜检查中具有较好的临床应用价值.     

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 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.     

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.     

Fields of applications,diagnostic yields and findings of OMOM capsule endoscopy in 2400 Chinese patients

AIM:To retrospectively analyze the fields of application,diagnostic yields and findings of OMOM capsule endoscopy in Chinese patients.METHODS:A database including 2400 Chinese patients who received OMOM capsule endoscopy in 27 endoscopy centers in China was retrieved from the Jianshan Science and Technology Ltd.OMOM capsule endoscopy database.The patient's age,gender,fields of application,the potentially relevant findings,pyloric transit time(PTT),small bowel transit time(SBTT),and complete small-bowel exam...     

Improved capsule endoscopy after bowel preparation

BACKGROUND: The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small-bowel wall and complete passage through the small bowel. This study examined the effect of bowel preparation on the volume of intestinal content and on small-bowel transit. METHODS: Sixty-one consecutive patients (34 men, 27 women; mean age 56 years, range 17-88 years) were enrolled in the study. Although not randomized, 33 patients received a bowel preparation, and 28 had no preparation. Gastric emptying, small-bowel transit time, overall preparation assessment, and bowel-wall visualization were evaluated by 3 investigators who were unaware of whether the patient had undergone bowel preparation. RESULTS: Small-bowel transit time was significantly shorter in patients with bowel preparation (median 213 minutes: 95% CI[190, 267]) than in those without preparation (median 253 minutes: 95% CI[228, 307]) (p <0.01). The capsule reached the cecum in 97% of patients in the bowel-preparation group, compared with 76% in the nonpreparation group (p=0.02). Bowel preparation improved the quality of visualization significantly; this effect was more pronounced in the distal small bowel. CONCLUSIONS: This study demonstrated that bowel preparation accelerates small-bowel capsule transit and leads to a higher rate of complete capsule endoscopy. Visualization of the small bowel was improved by bowel preparation. Bowel preparation before capsule endoscopy is recommended.     

Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide

BACKGROUND: Passage of the capsule endoscope to the colon occurs in only approximately three quarters of patients. This study assessed factors that might influence the completeness of small-bowel transit, including orally administered metoclopramide. METHODS: Clinical and procedural parameters were recorded prospectively for 150 patients undergoing capsule endoscopy. Metoclopramide was not administered to the first 83 patients (Group 1) but was given orally (10 mg) to the subsequent 67 (Group 2). RESULTS: Small-bowel transit was complete in 63 patients in Group 1 (76%). Gastric transit time was significantly longer when the capsule did not reach the colon than when it did (114.9 +/- 32.6 minutes vs. 26.6 +/- 2.9 minutes; p=0.007). Small-bowel transit time also was longer. The likelihood of complete small-bowel passage was not predicted by any clinical or procedural factor. In Group 2 (metoclopramide), the capsule reached the colon in 65 (97%) patients (OR 10.3: 95% CI[2.32, 93.55], p <0.001). This improvement was associated with a significant reduction in gastric transit time (47.9 +/- 9.0 minutes vs. 30.8 +/- 7.5 minutes; p=0.025). CONCLUSIONS: Metoclopramide increases the likelihood of a complete small-bowel examination in patients undergoing capsule endoscopy.     

187例OMOM胶囊内镜回顾性分析

目的 探讨胶囊内镜(CE)对小肠疾病的诊断价值及未完成全小肠检查(UCSE)的危险因素.方法 收集2016年5月至2019年5月于武汉大学人民医院连续进行OMOM胶囊内镜检查的187例患者的相关临床资料,回顾性分析CE小肠病变检出和诊断情况、全小肠检查完成情况及UCSE的可能危险因素.结果 CE小肠病变检出率为64.2...     

Effect of three bowel preparations on video-capsule endoscopy gastric and small-bowel transit time and completeness of the examination

OBJECTIVE: Video capsule endoscopy fails to visualize the caecum in about 20% of patients. The aim of this study was to investigate the effect of different bowel preparations on video capsule endoscopy gastric- (GTT) and small-bowel transit time (SBTT) and the rate of caecal visualization. MATERIAL AND METHODS: We retrospectively examined 186 consecutive capsule endoscopy videos undertaken over a 3-year period, excluding cases with diabetes mellitus or gastric surgery (n=28), cases with unknown bowel preparation and those with unreadable data CDs (n=27). Sixty-seven (36%) patients were prepared with a liquid diet (CL), 54 (29%) with sodium phosphate (PS) and 65 (35%) with polyethylene glycol (PEG). Two independent, experienced investigators examined the videos. RESULTS: No difference was found in GTT among CL, PS and PEG preparations (25, 6.7-116.2 min, 34.75, 4.1-125 min, 35, 6.1-128.6 min, respectively, p=0.29). The caecum was visualized in 56/67 (83.6%), 44/54 (81.5%) and 53/65 (81.5%) patients who received CL, PS and PEG, respectively (p=0.9). In the cases where capsule endoscopy reached the caecum, no difference was observed in SBTT among patients that received CL, PS and PEG (264.4+/-85.9 min, 296.7+/-79.5 min, 291.3+/-84 min, respectively, p=0.11). CONCLUSIONS: Bowel preparations for capsule endoscopy do not have a significant effect on gastric and small-bowel video capsule transit time and the rate of caecum visualization.