链霉蛋白酶应用于胃镜检查的效果观察

Application of Pronase in Gastroscopy

目的探讨链霉蛋白酶在胃镜检查中的应用效果。方法将接受胃镜检查的270例患者按随机数字表法分为2组:试验组129例,检查前30min口服链霉蛋白酶和碳酸氢钠的混合液50mL,并于检查前10min口服盐酸利多卡因胶浆10mL;对照组141例,检查前10min口服盐酸利多卡因胶浆10mL。胃镜检查时分别对胃底、胃体上部、胃体下部、胃窦的黏膜清晰度进行评分,比较2组萎缩性胃炎及伴有肠上皮化生检出率。结果试验组胃底、胃体上部、胃体下部、胃窦黏膜以及总黏膜清晰度评分分别为(1.81±0.88)、(1.53±0.72)、(1.29±0.50)、(1.47±0.71)、(6.09±1.87)分,对照组分别为(2.48±0.67)、(2.37±0.80)、(2.31±0.78)、(2.12±0.83)、(9.23±2.39)分,试验组各部位及总胃黏膜评分均显著低于对照组,差异有统计学意义(P<0.001)。试验组对萎缩性胃炎及伴有肠上皮化生检出率显著高于对照组(17.8%比10.6%,P<0.05)。结论链霉蛋白酶能有效提高胃镜检查时胃黏膜清晰度,有利于胃黏膜微小病变的发现。

Objective To explore the efficacy of pronase in gastroscopy. Methods A total of 270 patients scheduled for gastroscopy were randomly divided into two groups. The study group ( n — 129) were orally given 50 mL mixture containing pronase and sodium bicarbonate 30 minutes before gastroscopy, and 10 mL lidocaine hydrochloride mucilage 10 minutes before gastroscopy.The control group(n= 141) only received 10 mL lidocaine hydrochloride mucilage 10 minutes before gastroscopy. The gastric mucosal visibility was regarded in the gastric fundus, upper gastricbody, lower gastric body, and gastric antrum. In addition, the detection rate of atrophic gastritis accompanied by intestinal metaplasia was compared between the two groups. Results The mucosal visibility scores for gastric fundus, upper gastric body, lower gastric body and gastric antrum were,respectively, 1. 81zt〇. 88,1. 53 zt 0. 72,1. 29 zt 0. 50 and 1. 47zt〇. 71 in study group, and 2. 48 zt0. 67,2. 37zt〇. 80,2. 31zt〇. 78 and 2. 12zt〇. 83 in control group. The total mucosal visibility scores were 6 .〇9士 1. 87 and 9. 23士2. 39 in study group and control group, respectively. Compared with control group, pronase premedication decreased the mucosal visibility scores(P<C〇. 0 0 1 ),and increased the detection rate of atrophic gastritis accompanied by intestinal metaplasia(17. 8% vs 10. 6 % , P <C0 . 05). Conclusion Pronase premedication can improve gastric mucosal visibility andcontribute to the detection of minute lesions.