儿童磁控胶囊内镜检查前祛泡剂的应用研究

Application of defoaming agents prior to magnetically controlled capsule endoscopy in pediatric patients

摘要:

目的 探讨儿童磁控胶囊内镜检查前，采用不同剂型、不同服用时间的祛泡剂，对胃部视野清晰度的影响。方法 回顾性分析2017年1月至2023年3月于上海交通大学医学院附属儿童医院接受磁控胶囊内镜检查的病例资料，根据服用祛泡剂的类型分成西甲硅油乳剂组（10 mL西甲硅油乳剂）、二甲硅油散剂组（5 g二甲硅油散剂溶于30 mL温水）、二甲硅油乳剂组（4 mL二甲硅油乳剂溶于10 mL清水），每组再根据检查前服用时间分30 min、45 min、60 min亚组，共9组。主要评价指标为胃内气泡量评分，次要评价指标包括胃内清洁度评分、胃部检查时间、胃转运时间、诊断效能、安全性等。结果 每组20例患儿，9组共纳入180例患儿资料，其中二甲硅油散剂45 min组的胃内气泡量评分［（0.89±0.35）分］、胃内清洁度评分［（0.99±0.52）分］明显低于其余各组，即清晰度较高，差异有统计学意义（P<0.05）。各组胃部检查时间、胃转运时间、胃部疾病阳性检出率差异均无统计学意义（P>0.05）。结论 磁控胶囊内镜胃部检查前祛泡剂的服用可明显减少胃内的气泡量，增加胃部黏膜的清晰度，儿童服用方案选择检查前45 min服用溶于30 mL温水的5 g二甲硅油散剂更优。

Abstract:

Objective To investigate the effects of different types and administration times of defoaming agents on the gastric vision clarity before magnetically controlled capsule endoscopy (MCE) in children. Methods A retrospective analysis was conducted on children who underwent MCE in Shanghai Children""s Hospital, School of Medicine, Shanghai Jiao Tong University from January 2017 to March 2023.Children were divided into three groups based on type of defoaming agents: the simethicone emulsion group (10 mL simethicone emulsion), the dimethicone powder group (5 g dimethicone powder dissolved in 30 mL warm water), and the dimethicone emulsion group (4 mL dimethicone emulsion dissolved in 10 mL water). Each group was further divided into 3 subgroups based on the time of administration before the examination: 30 minutes, 45 minutes, and 60 minutes, resulting in a total of 9 subgroups. The primary outcome measure was the gastric bubble score. Secondary outcomes included gastric cleanliness score, examination time, gastric transit time (GTT), diagnostic efficacy, and safety assessment. Results A total of 180 children (20 per group) were included in the study. The gastric bubble score (0.89 ± 0.35) and gastric cleanliness score (0.99 ± 0.52) in the 45‑minutes subgroup of the dimethicone powder group were significantly lower than those in other groups, indicating better view clarity, with significant differences (P<0.05). There were no significant differences in examination time, GTT, or the positive detection rate of gastric diseases among the groups (P>0.05). Conclusion Administration of defoaming agents before MCE can significantly reduce gastric bubbles and improve the view clarity of the gastric mucosa. The optimal regimen for children is taking 5 g dimethicone powder dissolved in 30 mL warm water 45 minutes before the examination.