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Addition of Simethicone to Polyethylene Glycol Electrolyte Solution for Bowel Preparation Improves Colonoscopic Bowel Visualization

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English abstract

摘要

Contents

List of tables and figures

Preface

Chapter 1:The role of colonoscopy for screening and surveillance for early colorectal cancer

1.1 Quality of Colonoscopy

1.2 Sedation

1.3.1 NBI with magnifying colonoseopy

1.3.2 Vascular patterns of Magnirying NBI

1.1.3 Surface patterns of Magnifying NBI

1.4 Flexible Spectral Imaging Color Enhancement(FICE)

1.5 Blue Laser Imaging(BLI)

1.6 Confocal Laser Endomicroscopy

1.6.1 CLE classifications

1.6.2 Clinical applications

Chapter 2:Addition of Simethicone to Polyethylene Glycol Electrolyte Solution for Bowel Preparation Improves Colonoscopic Bowel Visualization:Literature Review

2.1 Factors associated with poor bowel preparation

2.2 Polyethylene glycol(PEG)

2.3 Split or single doses and adverse events

2.4 Simethicone

2.5 Patient’s tolerability,adverse events and procedure timing

2.6 Special patient subpopulation

2.6.1 Elderly patients

2.6.2 Diabetic patients

2.6.3 Pediatric population

2.6.4 Patients with renal failure

2.6.5 Pregnancy

Chapter 3:Methods and Materials

3.1 Inclusion and exclusion criteria

3.1.1 Inclusion criteria

3.1.2 Exclusion criteria

3.2 Study design and assessment

3.2.1 Bowel preparation instructions were as flows

3.2.2 Diet recommendations

3.2.3 Randomization

3.2.4 Bubbles grading

3.3 Statistical analysis

3.4 Results

3.4.1 Overview of demographics and indications

3.4.2 Assessment of bubbles grades and preparation quality

3.4.3 Purgative completion,tolerante,and side effects

Chapter 4:Discussion and conclusion

4.1 Discussion

4.2 Conclusion

Rerefences

Acknowledgement

Author’s profile

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摘要

背景:目前观察整个结肠最有效方法是通过结肠镜检查。为了获得好的结肠镜检查效果,良好的肠道准备是必须的。因为如果无法顺利完成整个结肠镜检查不仅会降低发现腺瘤和息肉的可能性,还会延期肠镜检查时间、影响患者耐受和对医生的满意度。医生在肠镜检查过程中遇到的最常见的问题是肠道汽包及粪水。而肠道中气泡的存在也会影响肠镜的观察。
  目的:本研究的目的是为了评估西甲硅油联合聚乙二醇进行肠道准备后,肠道气泡、患者耐受性和肠镜检查时间是否改善。
  方法:这是一项对3L聚乙二醇电解质溶液和聚乙二醇电解质溶液联合30ml西甲硅油两种方案进行比较的单中心前瞻性研究。门诊和住院患者在进行肠镜检查前随机使用一种方案。
  结果:本研究纳入了100名患者,每组50名,两组患者的年龄、性别和主要适应症无统计学差异。结果显示,在气泡分级上,PEG-S组中31名(62%)患者达到A级气泡,而对照组仅有11名(22%)达到A级;同时,实验组中有16名(32%)患者达到B级气泡,3名(6%)患者达到C级气泡,而对照组有25名(50%)患者达到B级,14名(28%)患者达到C级气泡,差异有统计学意义(P<0.001,Z=4.821)。此外,PEG-S组患者的冲洗明显减少(P=0.001,Z=3.804),西甲硅油组内镜医师的满意度也明显升高(P<0.0001,Z=4.093)。而在总检查时间、药物不良反应、患者耐受性和接受度方面两组无明显统计学差异。
  结论:在PEG的基础上加用西甲硅油能够有效去除气泡、显著减少冲洗次数,获得更好的准备效果。

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