| Background: Esophagogastroduodenoscopy(EGD)is the most useful method to diagnosis the upper digestive tract diseases,which can observe the lesions and execute biopsy directly.In most cases,there may be mucus and bubbles in esophageal and stomach of most patients,influencing the clarity of vision greatly.Therefore,some subtle lesions may be ignored,resulting in misdiagnosis,so different preoperative preparations to reduce bubbles and mucus are needed.Currently,simethicone is a useful bubble eliminating agent,while when to drink to achieve the best effect remains unclear.Recent studies have shown that,acetylcysteine can improve the clarity of vision by getting rid of the mucus in stomach,but there is no unified idea currently.Objective: To study the influence of bubble elimination effects in different drinking time of simethicone,and to explore the role of acetylcysteine in eliminating mucus,and to analyze whether the two have a synergistic effect in improving the clarity of endoscopy.Methods: Patients who received upper gastrointestinal endoscopy in operating room of digestive endoscopy of Second Hospital of Hebei Medical University from Nov.2015 to Jan.2016 were enrolled.They were randomly devided to three big groups according to the time of drinking simethicone: 10 min group(group A),20 min group(group B),and 30 min group(group C).There were four sub-packets in each group: simethicone + acetylcysteine group(group 1),simethicone(group 2),acetylcysteine(group 3),and Normal Saline(group 4).Each group took their drug according their requirements,and all patients immediately turned over one circle in clockwise and counterclockwise within 2 min.All patients took Dyclonine Hydrochloride orally 10 min before EGD.We observed and recorded each patient’s EGD clarity during EGD.The EGD clarity includes mucus and bubbles.The observation of bubble was divided into the four levels: excellent,good,fair and poor grade.We defined excellent and good as effective;defined fair and poor as invalid.The observation of mucus was expressed as a visibility score.The visibility score was determined by the adherent mucus amount and was scored from 1 to 4.We observed six different positions on the digestive tract,including the esophagus,the upper part of the gastric body,the lower part of the gastric body,antrum,gastric and duodenal cavity.The sum of the scores from the six locations was defined as the total mucosal visibility score.We analyzed the clarity of each group.Results: 1 240 patients were enrolled,7 cases excluded,and actually 233 cases completed the study.Age and gender composition of each group was no significant difference(F = 0.609,P = 0.821;χ2 = 7.297,P = 0.775).2 Effective rate of getting rid of bubble: The effective rate of simethicone group was 94.7%;while 63.8% in Normal Saline group,the difference was statistically significant(P <0.05).The effective rate of taking simethicone 10 min,20min,30 min preoperative was 95%,100%,88.9%,respectively,and there was no difference among 3 groups(P > 0.05).3 Effective rate of getting rid of mucus: The scores of simethicone group and acetylcysteine group were significantly lower than the Normal Saline group(P <0.05),but no statistically differences between 2 groups were observed(P > 0.05),and there were no synergistic effect between simethicone and acetylcysteine,either(P > 0.05).Conclusion: Preoperative 10~30 min taking simethicone can achieve same effects in eliminating bubbles.Simethicone and acetylcysteine were equivalent in getting rid of mucus in upper gastrointestinal tract.But there were no synergistic effect between simethicone and acetylcysteine in improving the clarity of endoscopy. |
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