链霉蛋白酶与二甲硅油对胃镜检查微小病变检出率影响的比较

Comparison of effects of streptavidin and dimethylsilicone oil on the detection rate of microscopic lesions under gastroscopy

探讨链霉蛋白酶与二甲硅油对胃镜检查微小病变检出率影响,统计353例接受无痛胃镜检查的患者,分为试验组(予链霉蛋白酶联合碳酸氢钠)176例和对照组(予二甲硅油联合碳酸氢钠)177例。记录两组胃镜检查时视野清晰度、检查时长、冲洗次数、微小病灶检出率、早期癌检出率及不良反应发生率等临床指标。试验组和对照组比较视野清晰度[(1.84±0.51)分比(2.15±0.48)分,t=-5.900]、胃底黏液性状[(1.04±0.43)分比(1.46±0.76)分,t=-6.347]和冲洗次数[(0.76±0.66)次比(1.18±0.72)次,t=-5.628]等方面,差异有统计学意义(P<0.001)。试验组检查时长略高于对照组[(10.01±4.40)min比(8.98±4.22)min,t=2.239,P=0.026]。试验组微小病变检出率显著高于对照组[97.73%(172/176)比91.53%(162/177),χ^(2)=6.665,P=0.010]。在炎性增生、息肉、癌前病变和癌的检出率方面,试验组与对照组差异均无统计学意义(P>0.05)。两组患者均无术前喝药不适,试验组和对照组各有4例发生术中呛咳,术中呛咳发生率差异无统计学意义(P>0.999),术后均无不良反应。术前服用链霉蛋白酶可显著提高胃镜下视野清晰度并提高微小病变检出率,有助于发现胃内早期病变。

To investigate the effects of streptavidin and dimethylsilicone oil on the detection rate of microscopic lesions under gastroscopy,a total of 353 patients who underwent painless gastroscopy were categorized into the experimental group(given streptavidin combined with sodium bicarbonate,n=176)and the control group(given dimethylsilicone oil combined with sodium bicarbonate,n=177).Clinical indexes such as visual field clarity,examination duration,number of rinses,detection rate of micro lesions,early cancer detection rate and incidence of adverse reactions were recorded in the gastroscopy examination of the two groups.The experimental and control groups were compared in terms of visual field clarity(1.84±0.51 points VS 2.15±0.48 points,t=-5.900),fundus mucus properties(1.04±0.43 points VS 1.46±0.76 points,t=-6.347)and number of rinses(0.76±0.66 times VS 1.18±0.72 times,t=-5.628)with significant differences(P<0.001).The examination time in the experimental group was slightly higher than that in the control group(10.01±4.40 min VS 8.98±4.22 min,t=2.239,P=0.026).The detection rate of microscopic lesions was significantly higher in the experimental group than that in the control group[97.73%(172/176)VS 91.53%(162/177),χ^(2)=6.665,P=0.010].There was no significant difference in the detection rate of inflammatory hyperplasia,polyps,precancerous lesions or cancer between the experimental group and the control group(P>0.05).There was no preoperative drinking discomfort in either group,and 4 cases of intraoperative choking occurred in each of the experimental and the control group with no significant difference(P>0.999).No postoperative adverse reaction occurred in either group.Taking streptavidin before operation could significantly improve visual field clarity and the detection rate of microscopic lesions,which helps to detect early lesions in stomach.