Helpfulness of the combination of acetic acid and FICE in the detection of Barrett's epithelium and Barrett's associated neoplasias

AIM:To investigate the mucosal morphology in Barrett's oesophagus by chromo and magnifying endoscopy.METHODS:A prospective pilot study at a tertiary medical centre was conducted to evaluate the use of acetic acid pulverisation combined with virtual chromoendoscopy using Fujinon intelligent chromoendoscopy(FICE) for semiological characterization of the mucosal morphology in Barrett's oesophagus and its neoplastic complications.Upper endoscopy using high definition whitelight,2% acid acetic pulverisation and FICE with high definition videoendoscopy were performed in 20 patients including 18 patients who presented with aspects of Barrett's oesophagus at endoscopy examination.Two patients used as controls had normal endoscopy and histological results.Prospectively,videos were watched blind from histological results by three trained FICE technique endoscopists.RESULTS:The videos of patients with high-grade dysplasia showed an irregular mucosal pattern in 14% using high definition white light endoscopy and in 100% using acid acetic-FICE combined.Videos did not identify irregular vascular patterns using high definition white light endoscopy,while acid acetic-FICE combined visualised one in 86% of cases.CONCLUSION:Combined acetic acid and FICE is a promising method for screening high-grade dysplasia and early cancer in Barrett's oesophagus.

预防性护理对CT增强扫描减轻碘造影剂致不良反应的护理效果分析

评估CT增强扫描期间行预防性护理对碘造影剂不良反应的影响。方法 纳入98例CT增强扫描患者,以此为样本,入院后随机分组,有预防组、基础组,样本在各组均是49例,前者行预防性护理,后者行基础性护理,样本均在2021年7月-2022年7月入选,统计不良反应,评估碘造影剂外渗程度,观察检查心态,调查护理满意度。结果 统计各方案下的不良反应,调查后在预防组为4.08%,计算落实后比基础组的18.37%低,P<0.05。评估各组方案下的碘造影剂外渗程度,调查后轻度率以及总发生率在预防组均为2.04%,计算落实后均比基础组(12.24%、14.29%)低,P<0.05。护理前针对检查心态进行评估,SAS、SDS在预防组、基础组间无差异,P>0.05。护理后针对检查心态进行评估,SAS、SDS在预防组比基础组低,P<0.05。评估各方案下的护理满意度,调查后在预防组为95.92%,计算落实后比基础组的79.59%高,P<0.05。结论 预防性护理可推广,能减少碘造影剂使用期间的不良反应,也能防控外渗问题,保持良好心态,提高CT增强扫描安全性。