在食管胃十二指肠镜检查中，预用药溶黏剂是否能改善粘膜的显像:一项系统回顾和荟萃分析。

Surgery Research and Practice Pub Date : 2021-01-22 eCollection Date: 2021-01-01 DOI:10.1155/2021/1570121

Eoghan Burke, Patricia Harkins, Frank Moriarty, Ibrahim Ahmed

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引用次数: 2

摘要

胃癌(GC)是世界上第四大最常见的恶性肿瘤，也是男女癌症相关死亡率的第二大原因。诊断胃癌的金标准是食管胃十二指肠镜检查(OGD)。胃粘膜粘液过多妨碍早期胃癌的检测。目的:综合现有证据，在选择性非治疗性OGD的成人中，与安慰剂或其他黏液剂相比，在OGD期间，预用药时使用黏液剂对粘膜可视性的影响。方法:进行系统评价。检索PubMed、EMBASE、CINAHL、Cochrane中央对照试验注册库(central)和Web of Science等相关研究。进行随机效应荟萃分析，以确定总粘膜可见性评分(TMVS)的平均差异在混合溶黏液剂和对照组之间。进行亚组分析，以确定西甲硅氧烷组与对照组的平均TMVS差异，以及不同时间和剂量的预溶黏液药物的影响。结果:共纳入13项研究，共纳入11086例患者，其中女性6178例(55.7%)，平均年龄53.4岁，其中6项纳入meta分析。结果显示，混合溶黏剂与对照组的总粘膜可见性评分(TMVS)平均差异为-2.69 (95% CI -3.5， -1.88)。西甲硅氧烷的平均差异为-2.68 (95% CI -4.94， -0.43)。西甲硅氧烷剂量133 mg最有效，平均差值为-4.22 (95% CI -5.11， -3.33)。评估所有黏液溶解剂的给药时间显示>20分钟组的平均差异为-3.68 (95% CI -4.77， -2.59)。在所有纳入的试验中均未报告不良事件。结论:常规OGD前定期使用黏液溶解剂与TMVS改善相关，无不良事件报告。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Does Premedication with Mucolytic Agents Improve Mucosal Visualization during Oesophagogastroduodenoscopy: A Systematic Review and Meta-Analysis.

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Does Premedication with Mucolytic Agents Improve Mucosal Visualization during Oesophagogastroduodenoscopy: A Systematic Review and Meta-Analysis.

Introduction: Gastric Cancer (GC) is the fourth most common malignancy worldwide and the second leading cause of cancer-related mortality for both sexes. The gold standard for diagnosing GC is oesophagogastroduodenoscopy (OGD). Excess mucus on the gastric mucosa impairs the detection of early GC.

Aim: To synthesize available evidence of the effect of premedication with a mucolytic agent among adults undergoing elective nontherapeutic OGD, compared to placebo or other mucolytic agents, on mucosal visibility during OGD.

Methods: A systematic review was conducted. PubMed, EMBASE, CINAHL, Cochrane central register of controlled trials (CENTRAL), and Web of Science were searched for relevant studies. A random-effects meta-analysis was performed to determine the mean difference in total mucosal visibility score (TMVS) between the pooled mucolytic agents and control. Subgroup analyses were performed to determine the mean TMVS difference for simethicone versus control and the impact of different timings and doses of mucolytic premedication.

Results: 13 studies, involving 11,086 patients, including 6178 females (55.7%), with a mean age of 53.4 were identified and 6 of these were brought forward to meta-analysis. This revealed a mean difference of -2.69 (95% CI -3.5, -1.88) in total mucosal visibility scores (TMVS) between the pooled mucolytic agents and control. For simethicone, the mean difference was -2.68 (95% CI -4.94, -0.43). A simethicone dose of 133 mg was most effective with a mean difference of -4.22 (95% CI -5.11, -3.33). Assessing timing of administration across all mucolytic agents revealed a mean difference for the >20 minutes group of -3.68 (95% CI -4.77, -2.59). No adverse events were reported in any included trials.

Conclusions: Regular use of premedication with mucolytic agents prior to routine OGD is associated with improved TMVS with no reported adverse events.

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Surgery Research and Practice

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期刊介绍： Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.