双倍剂量链霉蛋白酶联合西甲硅油改善胃内清洁度的临床研究

Improvement of gastric cleanliness by double-dose pronase and simethicone:A clinical study

背景胃清洁度是影响胃镜检查质量的重要因素.链霉蛋白酶是一种蛋白分解酶,可切断胃粘膜中的黏蛋白肽键,提高胃清洁度.双倍剂量的链霉蛋白酶可充分发挥祛除黏液疗效,联合西甲硅油可进一步提升胃内视野.目的探讨双倍剂量链霉蛋白酶联合西甲硅油在改善胃镜检查胃内清洁度方面的疗效和安全性.方法采用随机对照的方法,将126例接受胃镜检查的患者分为三组:不含链霉蛋白酶的对照组、单倍剂量链霉蛋白酶组和双倍剂量链霉蛋白酶组.观察各组在检查时胃内不同部位的清洁度、内镜操作时间、病灶检出率及不良反应等指标.结果与对照组相比,双倍链霉蛋白酶组的胃内清洁度评分更高(P<0.01),内镜操作时间更短(P<0.01),但病灶检出率没有显著差异.同时,各组在不良反应发生率上也没有显著差异(P>0.05).结论双倍剂量链霉蛋白酶优于单倍剂量链霉蛋白酶作为胃镜检查术前准备药物,能够明显改善胃内清洁度,减少内镜操作时间,并且具有较高的安全性.

BACKGROUND Gastric cleanliness plays an important role in the quality of gastroscopy.Pronase is a protein-breaking enzyme that can cut mucin peptide bonds in the gastric mucosa and improve gastric cleanliness.Double-dose pronase can give full play to the effect of removing mucus,and when combined with siloxane oil,it can improve the gastric visual field.AIM To investigate the efficacy and safety of double-dose pronase and simethicone in improving gastric cleanliness for gastroscopy.METHODS A randomized controlled trial was conducted,involving 126 patients undergoing gastroscopy.The patients were divided into three groups:A control group without pronase,a single-dose pronase group,and a double-dose pronase group.The cleanliness of different gastric regions,time of the endoscopic procedure,rate of positive findings,and adverse reactions were observed in each group.RESULTS Compared to the control group,the double-dose pronase group showed significantly higher gastric cleanliness scores(P<0.01)and shorter time of endoscopic procedure(P<0.01).However,there was no significant difference in the rate of positive findings between the groups.Furthermore,there were no significant differences in the occurrence of adverse reactions among the groups(P>0.05).CONCLUSION Double-dose pronase is superior to single-dose pronase as a pre-procedural medication for gastroscopy,as it significantly improves gastric cleanliness,reduces endoscopic procedure duration,and has a higher level of safety.