链酶蛋白酶联合二甲基硅油对胃镜检查清晰度的影响

目的比较链酶蛋白酶联合二甲基硅油及糜蛋白酶联合二甲基硅油对胃镜检查清晰度影响效果。 方法选择2018年1月在山东省千佛山医院内镜中心接受胃镜检查的78例患者，按照随机、双盲原则平均分为2组，A组(链酶蛋白酶组)：2万U链酶蛋白酶＋1 g碳酸氢钠＋二甲基硅油5 g＋ 50 ml温水；B组(糜蛋白酶组)：4 000 U糜蛋白酶＋1 g碳酸氢钠＋二甲基硅油5 g＋50 ml温水。对比分析2组术中胃镜视野清晰度。 结果A组的胃窦、胃体、胃底黏膜清晰度及总内镜黏膜清晰度评分均明显优于B组(胃窦：1.7±1.0比1.2±0.5；胃体：2.6±0.8比2.1±0.8；胃底：1.9±0.8比1.5±0.7；总黏膜清晰度：6.2±2.1比4.7±1.6)，差异均有统计学意义(P均<0.05)。 结论链酶蛋白酶联合二甲基硅油能够明显提高胃镜检查清晰度，且效果明显优于糜蛋白酶联合二甲基硅油。

Effectiveness of pronase and premedication with dimethylpolysiloxane for visualization of the mucosa during gastroscopy

ObjectiveTo assess the efficacies of dimethylpolysiloxane plus pronase and dimethylpolysiloxane plus chymotrypsin for visualization of the mucosa during gastroscopy. MethodsA total of 78 patients taken gastroscopy in Department of Endoscopy, Qianfoshan Hospital of Shandong Province were selected in January 2018.All the patients were randomly and double-blindly divided into two groups equally.The patients in group A(pronase group)received the solution of 5 g dimethylpolysiloxane, 20 000 U pronase, 1 g sodium bicarbonate and 50 ml warm water.The patients in group B(chymotrypsin group)received the solution of 5 g dimethylpolysiloxane, 4 000 U chymotrypsin, 1 g sodium bicarbonate and 50 ml warm water.The vision clarity of the two groups was contrastively analyzed. ResultsThe antrum visibility, gastric body visibility, fundus visibility and the total visibility of group A were significantly higher than those of group B(antrum: 1.7±1.0 vs.1.2±0.5; gastric body: 2.6±0.8 vs.2.1±0.8; fundus: 1.9±0.8 vs.1.5±0.7; the total visibility: 6.2±2.1 vs.4.7±1.6), with statistically significant differences(all P<0.05). ConclusionCombined application of pronase plus dimethylpolysiloxane before gastroscopy significantly improves endoscopic visualization.And the effect is better than chymotrypsin plus dimethylpolysiloxane.