上消化道内镜检查前消泡剂含漱对咽部观察效果的影响研究

Effects of pre-procedure simethicone on detection of pharynx by upper gastrointestinal endoscopy

目的探讨消泡剂（西甲硅油乳剂）含漱在上消化道内镜检查时对咽部观察的影响。方法前瞻性纳入100例患有头颈部或食管鳞状细胞癌的患者，采用数字表法将患者随机分成2组。对照组按常规胃镜检查前准备；观察组除常规胃镜检查准备外，胃镜检查前1 min给予5 mL西甲硅油＋5 mL水混合液含漱。记录患者年龄，性别，肿瘤分期，咽部病变大小，医生满意度和检查时间，并进行统计学分析。结果2组患者基本情况，包括年龄、性别和肿瘤分期无明显差异（P〉0.05）。咽部表浅病灶对照组检出率为2.04%（1/49），观察组为8.16%（4/49），观察组高于对照组，但差异无统计学意义（P=0.362）。咽部观察时间观察组明显少于对照组（21.7 s比33.9 s，P=0.000），观察组内镜医生操作满意度整体优于对照组（P=0.001）。结论上消化道内镜检查前含漱西甲硅油乳剂可明显提高内镜观察视野，缩短咽部观察时间，提高头颈部早期鳞状细胞癌的检出率。

ObjectiveTo evaluate the clinical efficacy of pre-procedure simethicone on detection of pharynx by upper gastrointestinal endoscopy.MethodsA total of 100 patients with esophageal squamous cell carcinomas （ESCCs） were enrolled in this prospective controlled trial and randomly assigned into two groups. The study group was given gargle with 5 mL simethicone plus 5 mL water combined with conventional procedure before gastroscopy. The control group was prepared according to the conventional procedure. The age, gender, tumor stage, lesion size, doctor＇s satisfaction and examination time between two groups were analyzed.ResultsThe basic conditions between the two groups, including age, gender, and tumor stage were not significantly different （all P〉0.05）. The detection rate of superficial lesion in pharynx was higher in the study group than that in the control group, with no significant difference [8.16% （4/49） VS 2.04% （1/49）, P=0.362]. The median time of pharyngeal observation in the study group was less than that in the control group （21.7 s VS 33.9 s, P=0.000）. The doctor was more satisfied in the study group than the control group （P=0.001）.ConclusionPre-procedure with simethicone improves the endoscopic visibility and detection rate of superficial squamous cell carcinoma with less observation time.