不同祛泡剂在胃镜检查前处置中应用效果比较

Comparison of the effects of different defoaming agents in the treatment before gastroscopy

目的:不同祛泡剂在胃镜检查前处置中应用效果比较。方法:选取就诊的150例患者,分成A组、B组、C组三组,A组患者50例服用利多卡因胶浆,B组患者50例服用二甲硅油,C组患者50例服用西甲硅油。进行对照三组患者内镜检查的黏膜清晰度、细小病灶发现率、患者不良反应、行胃镜检查时间。结果:三组患者内镜下胃腔内黏膜的清晰程度评分总和,A组7.58±1.69;B组5.87±1.27;C组5.82±1.01;C组比B组及A组评分低,清晰度高。三组之间对照比较,差异有统计学意义(P<0.05)。对于微小病灶的检出情况,三组之间无明显差异,凸出的病灶且<5 mm项目比较,A、B、C三组之间的比较:χ2=6.922,P=0.031,C组、B组的内镜下凸出的病灶高于A组,且C组(30%)患者的内镜下凸出的病灶明显多于A组(10%),两组之间比较,差异有统计学意义(χ2=6.250,P=0.012)。结论:作为胃镜检查前应用的消泡剂,西甲硅油在提高内镜下黏膜的清晰度明显优于二甲硅油及对照组利多卡因,且在一定程度有利于发现微小病灶,值得被推广应用于临床。

Objective To investigatroe and compare effects of different defoming agents in the treatment before gastroscopy.Method We conducted a randomized controlled trail recruiting 150 patients undergoing gastroscopy.Patients were assigned 1∶1∶1 to received：Group A-drink lidocaine,group B-drink simethicone,group C-drink dimethyl silicone.The mucosal visibilityscore（MVS）,accuracy of small lesion diagnosis,adverse effects and total time for gastroscopy were compared among three group.Results The total score of endoscopic gastric mucosal clearance in three groups of patients was divided into three groups：group A,group B and group C,group A 7.58±1.69,group B 5.87±1.27,and group C 5.82±1.01.Compared with two methylene silicone oil group and lidocaine group,the score of the Western nail silicone oil group was lower and the clarity was higher.There was a difference between the three groups,and there was a statistical significance（P〈0.05）.For the detection of small lesions,there was no significant difference between the three groups,for the convex lesions and less than 5 mm,A,B and C between the three groups：χ^2=6.922,P=0.031.The endoscopic lesions in group C and group B were higher than those in group A,and C group（30%）had more prominent lesions than those in group A（10%）.There was a significant difference between two groups（χ^2=6.250,P=0.012）.Conclusion As a defoamer used before gastroscopy,the increase of clarity of endoscopic mucosal is better than that of two methylene silicone and control group lidocaine,and it is helpful for finding tiny lesions to some extent,which is worthy of popularization and application in clinic.