Optional dose of dimethicone in bowel preparation for small bowel capsule endoscopy: a multicenter randomized controlled trial

Lixue JIANG; Yang BAI; Tao DENG; Hong XU; Qiangqiang YANG; Kai QIAN; Xueli YANG; Guohua JIN; Xiaoyan ZHAO

doi:10.16016/j.1000-5404.202009008

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Optional dose of dimethicone in bowel preparation for small bowel capsule endoscopy: a multicenter randomized controlled trial

Clinical Medicine | 更新时间：2026-01-09

- Optional dose of dimethicone in bowel preparation for small bowel capsule endoscopy: a multicenter randomized controlled trial
- Journal of Third Military Medical University Vol. 43, Issue 4, Pages: 311-317(2021)
- 作者机构：
  
  1.400037 重庆，陆军军医大学第二附属医院消化内科
  2.510515 广州，南方医科大学南方医院消化内科
  3.430060 武汉，武汉大学人民医院消化内科
  4.130021 长春，吉林大学第一医院胃肠内科内镜中心
- 作者简介：
- 基金信息：
  
  the Special Project of Scientific Research for Public Welfare of National Health and Family Planning Commission(201502013)
- DOI：10.16016/j.1000-5404.202009008
  CLC： R181.32;R574;R981.2
- Received：02 September 2020，
  
  Revised：2020-11-25，
  
  Published：15 April 2021
- 稿件说明：
移动端阅览
Lixue JIANG, Yang BAI, Tao DENG, et al. Optional dose of dimethicone in bowel preparation for small bowel capsule endoscopy: a multicenter randomized controlled trial[J]. Journal of Third Military Medical University, 2021, 43(4): 311-317.
DOI：

Lixue JIANG, Yang BAI, Tao DENG, et al. Optional dose of dimethicone in bowel preparation for small bowel capsule endoscopy: a multicenter randomized controlled trial[J]. Journal of Third Military Medical University, 2021, 43(4): 311-317. DOI： 10.16016/j.1000-5404.202009008.

摘要

目的

研究不同剂量二甲硅油散对小肠胶囊内镜(small bowel capsule endoscopy

SBCE)肠道准备质量的影响，并探究二甲硅油散在SBCE肠道准备中的最佳剂量。

方法

采用多中心随机对照研究设计，自2016年5月至2019年1月纳入132名患者，平均分为3组，每组44人，所有患者在SBCE检查前6 h口服2 L复方聚乙二醇电解质散(polyethylene glycol

PEG)溶液清洁肠道，其中A组检查前30 min口服清水100 mL，B组检查前30 min口服浓度为2.5 g/100 mL二甲硅油散溶液100 mL，C组检查前30 min口服浓度为5 g/100 mL二甲硅油散溶液100 mL。主要评价指标为小肠气泡量(small bowel bubble quantity

SBBQ)、小肠有效图片率(small bowel valid picture ratio

SBVPR)、小肠清洁度(small bowel cleaning quality

SBCQ)，次要评价指标为胃气泡量(gastric bubble quantity

GBQ)、胃清洁度(gastric cleaning quality

GCQ)、全小肠检查完成率(completion rate

CR)、小肠疾病阳性检出率(diagnostic yield

DY)、胶囊通过小肠时间(small bowel transit time

SBTT)、胶囊通过胃时间(gastric transit time

GTT)。

结果

A组小肠近段、中段、远段气泡量均高于B组及C组(

0.05)，B组与C组间无统计学差异(

0.05)；A组近段、中段、远段小肠有效图片率均低于B组及C组(

0.05)，B组与C组间无统计学差异(

0.05)；A、B、C三组间小肠清洁度、胃气泡量、胃清洁度、全小肠检查完成率、小肠疾病阳性检出率、胶囊通过小肠时间及胶囊通过胃时间均无统计学差异(

0.05)。

结论

SBCE检查前服用二甲硅油散可有效消除小肠气泡，增加胶囊内镜下黏膜清晰辨别度，二甲硅油散的最佳剂量是2.5 g。

Abstract

Objective

To assess the effects of dimethicone at different doses in bowel preparation for small bowel capsule endoscopy (SBCE) and explore the optimal dose for the examination.

Methods

A multicenter randomized controlled trial (RCT) was carried out on 132 patients from 4 different institutions from May 2016 to January 2019. They were randomly divided into 3 groups

with 44 cases in each group. All of them were given 2 liters of polyethylene glycol (PEG) solution orally 6 h before procedure

and then in 30 min before examination

the patients were asked to drink 100 mL pure water

2.5 g and 5 g 100 mL dimethicone solution for those from group A

B and C

respectively. The primary evaluation indexes included small bowel bubble quantity (SBBQ)

small bowel valid picture ratio (SBVPR)

small bowel cleaning quality (SBCQ)

and the secondary evaluation indexes contained gastric bubble quantity (GBQ)

gastric cleaning quality (GCQ)

completion rate (CR)

diagnostic yield (DY)

and small bowel transit time (SBTT) and gastric transit time(GTT) of the capsule.

Results

The SBBQ of group A was higher than those of the other 2 groups in the proximal

middle and distal segments of small intestine (

0.05)

and there was no significant difference between group B and C (

0.05). Similar results were seen in the SBIRP in the 3 groups. No statistical significances were found in other indexes amon

g the 3 groups (

0.05).

Conclusion

Dimethicone treatment can efficiently decrease intraluminal bubbles and improve the visibility of small bowel mucosa for SBCE

and the optimal dose of dimethicone is 2.5 g.

关键词

Keywords

references

中国医师协会内镜医师分会消化内镜专业委员会, 中国抗癌协会肿瘤内镜学专业委员会.中国消化内镜诊疗相关肠道准备指南(2019, 上海)[J].中华内科杂志, 2019, 1;58(7): 485-495. DOI: 10.3760/cma.j.issn.0578-1426.2019.07.002.

Professional Committee of Digestive Endoscopy Endoscopic Physicians Branch of Chinese Medical Doctor Association, Professional Committee of Cancer Endoscopy China Anti-Cancer Association. Chinese guideline for bowel preparation for colonoscopy (2019, Shanghai)[J]. Chin J Intern Med, 2019, 1;58(7): 485-495. DOI: 10.3760/cma.j.issn.0578-1426.2019.07.002.

蔡顺天, 杨云生, 李中原, 等.胶囊内镜和小肠镜对小肠疾病诊断价值比较[J].解放军医学院学报, 2015, 36(8): 765-768. DOI: 10.3969/j.issn.2095-5227.2015.08.001.

CAI S T, YANG Y S, LI Z Y, et al . Comparison between capsule endoscopy and balloonenteroscopy in diagnos ing small bowel diseases[J ] . Acad J PLA Postgrad Med Sch, 2015, 36(8): 765-768. DOI: 10.3969/j.issn.2095-5227.2015.08.001.

ENNS R A, HOOKEY L, ARMSTRONG D, et al . Clinical practice guidelines for the use of video capsule endoscopy[J ] . Gastroenterology, 2017, 152(3): 497-514. DOI: 10.1053/j.gastro.2016.12.032.

NAM S J, KIM Y J, KEUM B, et al . Impact of diet restriction on bowel preparation for colonoscopy[J ] . Medicine (Baltimore), 2018, 97(41): e12645. DOI: 10.1097/md.0000000000012645.

李萍, 杨敏, 郑苏云.二甲硅油散在胶囊内镜检查中的应用[J].医学信息(中旬刊), 2011, 24(4): 1398. DOI: 10.3969/j.issn.1006-1959.2011.04.175.

LI P, YANG M, ZHENG S Y. The efficioncy of simethicone in the capsule endoscopy examination[J]. Med Inf Oper Sci Fasc, 2011, 24(4): 1398. DOI: 10.3969/j.issn.1006-1959.2011.04.175.

安媚, 薛常虎, 王永席, 等.聚乙二醇电解质散联合二甲硅油在胶囊内镜检查中的应用及护理[J].临床医学研究与实践, 2017, 2(32): 154-155. DOI: 10.19347/j.cnki.2096-1413.201732075.

AN M, XUE C H, WANG Y X, et al . Application and nursing of polyethylene glycol electrolyte powder combined withdimeticone in capsule endoscopy examination[J ] . Clin Res Pract, 2017, 2(32): 154-155. DOI: 10.19347/j.cnki.2096-1413.201732075.

ALBERT J, GÖBEL C M, LESSKE J, et al . Simethicone for small bowel preparation for capsule endoscopy: a systematic, single-blinded, controlled study[J ] .Gastrointest Endosc, 2004, 59(4): 487-491. DOI: 10.1016/s0016-5107(04)00003-3.

NIV Y. Efficiency of bowel preparation for capsule endoscopy examination: a meta-analysis[J]. World J Gastroenterol, 2008, 14(9): 1313-1317. DOI: 10.3748/wjg.14.1313.

OLIVA S, CUCCHIARA S, SPADA C, et al . Small bowel cleansing for capsule endoscopy inpaediatric patients: a prospective randomized single-blind study[J ] . Dig Liver Dis, 2014, 46(1): 51-55. DOI: 10.1016/j.dld.2013.08.130.

RONDONOTTI E, SPADA C, ADLER S, et al . Small-bowel capsule endoscopy and device-assistedenteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review[J ] . Endoscopy, 2018, 50(4): 423-446. DOI: 10.1055/a-0576-0566.

毕英杰, 孙士东, 王洪艳, 等.不同肠道准备方法在胶囊内镜检查前的应用效果分析[J].现代消化及介入诊疗, 2016, 21(02): 220-222. DOI: 10.3969/j.issn.1672-2159.2016.02.014.

BI Y J, SUN S D, WANG H Y, et al . Effect analysis of different bowel preparation methods before capsule endoscopy[J ] . Mod Digest Inter, 12016, 21(02): 220-222. DOI: 10.3969/j.issn.1672-2159.2016.02.014.

王家良, 许良智, 康德英, 等.临床流行病学-临床科研设计、测量与评价.第4版[M].上海:上海科学技术出版社, 2014. 61-62.

WANG J L, XU L Z, KANG D Y, et al . Clinical epidemiology: clinical research design, measurement and evaluation.(4th Edition)[M ] . Shanghai: Shanghai Scientific and Technical Publishers, 2014. 61-62.

杨强强, 邓涛, 徐红, 等.两种不同时间口服聚乙二醇对小肠胶囊内镜肠道准备效果影响的多中心随机对照研究[J].第三军医大学学报, 2018, 40(21): 1973-1977. DOI: 10.16016/j.1000-5404, 201807219.

YANG Q Q, DENG T, XU H, et al . Clinical efficacy of 2 schedules of oral polyethylene glycol solution for bowel preparations before small bowel capsule endoscopy: a multicenter, randomized controlled study[J ] . J Third Mil Med Univ, 2018, 40(21): 1973-1977. DOI: 10.16016/j.1000-5404, 201807219.

CHEN H B, HUANG Y, CHEN S Y, et al . Small bowel preparations for capsule endoscopy with mannitol and simethicone: a prospective, randomized, clinical trial[J ] . J Clin Gastroenterol, 2011, 45(4): 337-341. DOI: 10.1097/mcg.0b013e3181f0f3a3.

SPADA C, RICCIONI M E, FAMILIARI P, et al . Polyethylene glycol plus simethicone in small-bowel preparation for capsule endoscopy[J ] . Digestive Dis, 2010, 42(5): 365-370. DOI: 10.1016/j.dld.2009.07.017.

叶山亮, 徐扬志, 陈宇轩, 等.胶囊内镜图像质量低劣的原因分析[J].现代消化及介入诊疗, 2011, 16(002): 129-131. DOI: 10.3969/j.issn.1672-2159.2011.02.018.

YE S L, XU Y Z, CHEN Y X, et al . Analysis of the causes of poor image quality of capsule endoscopy[J ] . Mod Digest Inter, 2011, 16(002): 129-131. DOI: 10.3969/j.issn.1672-2159.2011.02.018.

YUNG D E, RONDONOTTI E, SYKES C, et al . Systematic review and meta-analysis: is bowel preparation still necessary in small bowel capsule endoscopy?[J ] . Expert Rev Gastroent, 2017, 11(10): 979-993. DOI: 10.1080/17474124.2017.1359540.

潘隐, 顾巧华.二甲硅油在肠道准备中的应用[J].当代临床医刊, 2016, 29(6): 2740-2741. DOI: 10.3969/j.issn.2095-9559.2016.06.118.

PAN Y, GU Q H. Application of dimethicone in bowel preparation[J]. J Contemp Clin Med, 2016, 29(6): 2740-2741. DOI: 10.3969/j.issn.2095-9559.2016.06.118.

苏晓怡, 包洁.复方聚乙二醇电解质散与西甲硅油在胶囊内镜肠道检查中的应用[J].现代消化及介入诊疗, 2019, 024(005): 471-473, 477. DOI: 10.3969/j.issn.1672-2159.2019.05.005.

SU X Y, BAO J. Application of polyethylene glycol-electrolyte and simethicone in capsule endoscopy intestinal examination[J]. Mod Digest Inter, 2019, 24(05): 471-473. DOI: 10.3969/j.issn.1672-2159.2019.05.005.

OFSTEAD C L, WETZLER H P, JOHNSON E A, et al . Simethicone residue remains inside gastrointestinal endoscopes despite reprocessing[J ] . Am J Infect Control, 2016, 44(11): 1237-1240. DOI: 10.1016/j.ajic.2016.05.016.

THAKER A M, MUTHUSAMY V R. Innocent bystanders or legitimate culprits? The role of moisture and simethicone in endoscopically transmitted infections[J]. Gastrointest Endosc, 2019, 89(1): 133-136. DOI: 10.1016/j.gie.2018.09.034.

祝洋.不同剂量二甲硅油散应用在肠镜检查中的效果分析[J].中外女性健康研究, 2017(04): 153-174. DOI: 10.3969/j.issn.2096-0417.2017.04.108.

ZHU Y. Effect analysis of different doses of dimethicone powder in colonoscopy[J]. Women Heal Res, 2017(04): 153-174. DOI: 10.3969/j.issn.2096-0417.2017.04.108.

SONG H J, MOON J S, DO J H, et al . Guidelines for bowel preparation before video capsule endoscopy[J ] . Clin Endosc, 2013, 46(2): 147-154. DOI: 10.5946/ce.2013.46.2.147.

SONG H J, MOON J S, SHIM K N. Optimal bowel preparation for video capsule endoscopy[J]. Gastroenterol Res Pract, 2016, 2016: 1-7. DOI: 10.1155/2016/6802810.

ROSA B J, BARBOSA M, MAGALHÃES J, et al . Oral purgative and simethicone before small bowel capsule endoscopy[J ] . World J Gastrointest Endosc, 2013, 5(2): 67-73. DOI: 10.4253/wjge.v5.i2.67.

KRIJBOLDER M S, GROOTEMAN K V, BOGERS S K, et al . Addition of simethicone improves small bowel capsule endoscopyvisualisation quality[J ] . Neth J Med, 2018, 76(1): 27-31.

陈孝, 张子其, 张钰, 等.肠道准备对胶囊内镜图像质量及消化道通过情况的影响[J].中华消化内镜杂志, 2007, 24(1): 35-37. DOI: 10.3760/cma.j.issn.1007-5232.2007.01.009.

CHEN X, ZHANG Z Q, ZHANG Y, et al . The effect of bowel preparation on capsule endoscopy hnage and gastrointestinal transit time[J ] . Chin J Dig Endosc, 2007, 24(1): 35-37. DOI: 10.3760/cma.j.issn.1007-5232.2007.01.009.

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