| Background and ObjectivePCLE is a new kind of technology which can help doctors get real time observation of histological changes of gastric and intestinal mucosa.The application of PCLE requires high level of stability.In colonoscopy examination especially,the peristalsis of colon will impact observation heavily. In the traditional colonoscopy,using Scopolamine Hydrobromide can restrain peristalsis which will improve the quality of picture,reduce the examination time and increase the diagnostic accuracy. The application value of Scopolamine Hydrobromide is not clear in PCLE examination.The objective of this study is to analyse the application value of Scopolamine Hydrobromide in PCLE colonoscopy examination.MethodsPatients who were scheduled for PCLE examination from June 1 st to January 31st, 2014 in the Endoscopic Unit of Shandong University Qilu Hosopital were recruited in this study. Patients with the ages younger than 18 or older than 80 allergy to fluorescein sodium, jaundice, renal dysfunction, pregnancy or breast-feeding, usage of coagulopathy agents, strictures blocking complete examination were excluded.All the included patients have given their written informed consents The included patients were randomly assigned to receive lml Scopolamine Hydrobromide or normal saline. Allocation of randomization was performed by a nurse who did not know the purpose of this study according to a random sequence generated by computer. Patients were intravenously given 1 ml of 2% fluorescein sodium 20 minutes prior to the CLE examination for allergy test. All the procedures were performed under anesthesia with Propofol and electrocardiograph monitoring. Patients were intravenously given 1 ml Scopolamine Hydrobromide or normal saline 5 minutes prior to colonoscopy examination.Intubation into terminal ileum was to be achieved for each patient. Once intubation was successful or failed,6 ml of 10% fluorescein sodium was intravenously given. We choose a random point in each following intestinal segment.terrmnal ileum, ileocecus, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, the rectosigmoid junction, rectum.PCLE examinations for detected lesions and random points were performed during withdrawl.Keep recording of every lesion and take biopsies if necessary.Record the time of intubation and the whole procedure.ResultsA total of 66 patients were recruited for the CLE examinations.6 patients were excluded:1 for flurescein positive allergy test,1 for older than 80, and 2 for strictures blocking complete observation and 2 for poor bowel preparation. In the end 60 patients were included for analysis, with 38 males and 22 females. Average age is 47.32 years old. Average procedure time of examination group for colonoscopy was 20.48 ± 12.69(MEAN ± SD) minutes, average procedure time of contrast group was 29.89 ± 13.60 (MEAN ± SD) minutes. The time of procedures using Scopolamine Hydrobromide is significantly shorter.25 patients (25/30) in the examination group could be intubated into the terminal ileum, while 27 (27/30) patients in the contrast group could be intubated into the terminal ileum. The intubation rate of colonoscopy is not significantly different between two groups.For lesions and random points except the one of splenic flexure, image or video acquisition of two groups of PCLE also showed no differences regarding difficulties.ConclusionsUsing Scopolamine Hydrobromide can not improve detection rate and image or video acquisition while it can reduce the examination time.In conclusion we can use Scopolamine Hydrobromide in PCLE colonoscopy examination. |
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