二甲硅油散联合糜蛋白酶在胃镜检查中的应用效果

Application of dimethicone power combined with chymotrypsin in gastroscopy

目的探讨二甲硅油散联合糜蛋白酶在胃镜检查中的应用效果.方法抽取2018年1月至10月于常熟市第一人民医院接受常规胃镜检查的门诊和住院者2032例,其中胃镜检查前口服二甲硅油散508例,口服糜蛋白酶512例,口服二甲硅油散+糜蛋白酶519例,无口服药物493例.比较受检者胃镜视野清晰度、检查时间、检查后不适反应、医生满意度和病变检出情况.结果2032例受检者均完成胃镜检查,检查过程中未见严重不良反应.口服二甲硅油散+糜蛋白酶者胃镜视野清晰度和医生满意度高于口服二甲硅油、糜蛋白酶者及无口服药物者(P<0.01).口服二甲硅油散+糜蛋白酶者胃镜检查时间少于口服二甲硅油、糜蛋白酶者及无口服药物者(P<0.01).口服二甲硅油散+糜蛋白酶者上皮内瘤变和早期胃癌检出率分别为6.0%(31/519)和1.7%(9/519),高于其他辅助用药者、无口服药物者(P<0.05).结论胃镜检查前口服二甲硅油散和糜蛋白酶,可增加视野清晰度和医生满意度,减少检查时间,提高早期胃癌和癌前病变的检出率.

Objective To investigate the application value of premedication with dimethicone power and chymotrypsin in gastroscopic examination.Methods A total of 2032 outpatients and inpatients who received routine gastroscopy at the First People's Hospital of Changshu from January to October 2018 were selected.Among them,508 patients were given dimethicone before oral endoscopy,512 cases took oral chymotrypsin,519 cases orally took sputum+chymotrypsin,and 493 cases didn't take oral medication.The visual field clarity of the subject,the examination time,the discomfort after the examination,the doctor's satisfaction and the detection of the lesion were compared.Results The 2032 subjects underwent gastroscopy,and no serious adverse reactions were observed during the examination.Patients with oral dimethicone disperse+chymotrypsin had higher visual field clarity of the endoscopy and better doctor satisfaction than patients with oral dimethicone,chymotrypsin and no oral medication(P<0.01).The time of gastroscopy for dimethicone powder+chymotrypsin was lower than that of patients who took oral dimethicone,chymotrypsin and no oral drug(P<0.01).The detection rates of intrathecal neoplasia and early gastric cancer in patients with oral dimethicone+chymotrypsin were 6.0%(31/519)and 1.7%(9/519),respectively,higher than those of patients with other adjuvants and those without oral medication(P<0.05).Conclusions Premedication with dimethicone power combined with chymotrypsin before gastroscopy can not only improve the mucosal visibility of the stomach and reduce examination time,but also improve the detection rate of early gastric cancer and precancerous lesions.