全景胃镜对十二指肠主乳头观察的随机对照研究

Detection of major duodenal papilla using full-spectrum endoscopy: a randomized controlled trial

目的探讨全景胃镜对十二指肠主乳头观察的效果和安全性。方法2017年3月至2017年12月在解放军总医院消化内镜中心接受无痛胃镜检查的患者按照随机化分组、自身对照原则,将符合入选标准的研究对象按就诊顺序编号,采用随机数字表法随机分为两组,分别进行普通胃镜检查(A组)或者全景胃镜检查(B组)。以十二指肠主乳头的观察情况作为主要评价指标,比较两组对十二指肠主乳头的观察率。结果根据入组标准共纳入100例患者,其中A组51例、B组49例。B组十二指肠主乳头全部观察率优于A组[79.59%(39/49)比41.18%(21/51),χ^2=15.366,P=0.000],而对十二指肠主乳头的总体观察率(全部、部分观察率之和)与A组比较差异无统计学意义[100.00%(49/49)比92.16%(47/51),χ^2=2.221,P=0.136]。所有患者顺利完成检查,无出血、穿孔、死亡等并发症发生。结论全景胃镜广阔的视野有效提高了十二指肠主乳头观察的有效性和安全性。

Objective To evaluate the efficiency and safety of full-spectrum endoscopy for detection of major duodenal papilla. Methods Patients underwent painless gastroscopy in Chinese PLA General Hospital from March 2017 to December 2017 were enrolled and randomly divided into two groups according to random number method. The group A underwent conventional gastroscopy, and the group B underwent full-spectrum endoscopy. The detection rate of major duodenal papilla was calculated and compared between the two groups. Results A total of 100 patients were recruited in the study, including 51 in the group A and 49 in the group B. The whole detection rate of major duodenal papilla of the group B was higher than that of the group A [79.59%(39/49) VS 41.18%(21/51),χ^2=15.366, P=0.000]. There was no statistical difference on the whole plus partial detection rate of major duodenal papilla between the two groups [100.00%(49/49) VS 92.16%(47/51),χ^2=2.221, P=0.136]. All patients completed endoscopy examination succesfully without bleeding, peforation or death. Conclusion With the broad view-field, full-spectrum endoscopy is useful to improve the efficiency and safety in detection of major duodenal papilla.