伊托必利在胶囊内镜检查中的应用价值

Effect of Itopride on Capsule Endoscopy

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(P<0.05)。试验组胶囊胃转运时间显著短于对照组(P<0.05),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(P>0.05)。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。

Background ： Capsule endoscopy is the first choice for diagnosis of small bowel diseases. Cleanliness of intestine and gastrointestinal motility are crucial factors that affect the quality of capsule endoscopy. Aims： To investigate the effect of itopride on capsule endoscopy. Methods： Eighty patients who underwent capsule endoscopy for suspected small bowel diseases from Aug. 2014 to Oct. 2015 at Dianjiang People＇ s Hospital of Chongqing were recruited consecutively and randomly assigned into treatment group and control group. Patients in treatment group took itopride 50 mg tid orally one day before capsule endoscopy and itopride 50 mg 30 min before bowel preparation. Bowel preparation in both groups was conducted by using polyethylene glycol. Defecation, gastrointestinal transit time of capsule, cleanliness of small intestine, and lesion detection rate of capsule endoscopy between the two groups were compared. Results： The occurring of first defecation and stool cleansing time in treatment group were significantly shorter than those in control group （ P 〈 0.05 ）, and the stool frequency in treatment group was significantly higher （ P 〈 0.05 ）. More adverse events were observed in control group than in treatment group （P 〈 0.05）. Gastric transit time of capsule was significantly shorter in treatment group than in control group （ P 〈 0.05 ）, but no significant differences were seen in small intestinal transit time of capsule, cleanliness of small intestine, and the lesion detection rate between the two groups （ P 〉 O. 05 ）. Conclusions： Taken itopride orally before bowel preparation of capsule endoscopy may shorten the time of bowel preparation, improve the patients＇ compliance and reduce the gastric transit time of capsule for ensuring the adequate examination of small intestine. It is a preferable choice for capsule endoscopy bowel preparation.